I suspect many individuals (myself included) would believe that coordinating between hospice during end of life and an assisted living facility would be well organized and part of the assisted living facility?s normal routine. ?An article from the New York Times this week has me scratching my head.
?[A]rranging for?hospice care?in assisted living facilities presents challenges. A handful of states ? Idaho, Mississippi, Montana, and North Dakota ? won?t allow hospice services to be provided at assisted living centers, deeming the needs of end-of-life residents too demanding for these facilities. South Carolina requires a waiver for hospice services in assisted living. Other states, including Alaska, Arkansas, Florida, Rhode Island, West Virginia and Vermont, will allow existing residents to receive hospice services but won?t accept new residents who require end-of-life care.
A common misunderstanding surrounds how much attention assisted living centers can give to someone who is terminally ill and whose medical needs are intensifying. ?Assisted living is not like a nursing home: staffing ratios are much lower, and less help is available,? said Beth Breen, senior executive director of three assisted living centers for Centura Health at Home, a division of Colorado?s largest hospital network.
?If a person is still ambulating and transferring? in and out of a bed or a chair on his own, she said, ?and the family helps out, assisted living is absolutely appropriate. But if he can?t do this, the family will have to bring in help from an outside agency and pay for that care out of pocket.?
Assisted Living vs. Hospice: Who?s in Charge?
Wow. ?At a time when a caregiver and family needs to be able to focus on nurturing their care recipient/loved one, a new nightmare of health care administration comes into play. ?Apparently it is unreasonable to think that assisted living facilities are prepared to cope with the realities of death and dying:
??Sometimes, assisted living staff may not be comfortable with death and dying or the hospice philosophy. They may be thinking ?is hospice coming in here to do harm to this resident?,?? especially when treatments for an incurable illness are stopped, said Kevin Clark, director of two hospice programs associated with Centura Health at Home.
Also, ?assisted living staff can be very nervous about dealing with narcotics? prescribed by hospice doctors to control pain, Mr. Clark said, noting that educating staff about opioids, what they?re used for, how to administer them and the overall approach of hospice care is often necessary.
Many assisted living centers won?t allow hospice ?care kits? stocked with medications such as morphine, Haldol and Ativan on their premises. Such kits are routinely distributed to patients receiving hospice services in their homes, so caregivers can administer the medications as needed to control ?breakthrough? pain, said Dr. David Koets, chief medical officer of The Denver Hospice.
Important issues to consider when deciding on living arrangements for the aging individual. ?For those who are already in, or have loved ones in, assisted living, the Times columnist promises more information to come on what to look out for and questions to ask when bringing hospice into an assisted living environment. ?Stay tuned.
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Related Posts:
- Assisted Living Facility: One Bad Apple
- Assisted Living: Day Dream or Nightmare
- Alzheimer?s Disease: Making the Move to Assisted Living ? One Family?s Experience
- 7 Facts About Hospice
- Hospice: What to Know When Choosing a Hospice Provider
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