Thirty years ago, Medicare developed the Medicare Hospice Benefit, and quite by coincidence a small group of forward-thinking Kauai people developed Kauai Hospice. It would be another 13 years before Kauai Hospice became a Medicare Certified Hospice Provider. We are Kauai’s
Thirty years ago, Medicare developed the Medicare Hospice Benefit, and quite by coincidence a small group of forward-thinking Kauai people developed Kauai Hospice. It would be another 13 years before Kauai Hospice became a Medicare Certified Hospice Provider. We are Kauai’s only hospice, and not related by ownership to any other hospice or organization.
Hospice is intended to help care for patients in their homes during the final six months of life. In most cases that is a private home, but about 20 percent of the time their home is an assisted living, care home, or long-term care facility.
These people are all entitled to the same Hospice benefit and this benefit is at no charge. The patient should have family or care providers at their home and be referred by their doctor in order to be eligible. After an information visit, if the patient is eligible, an experienced hospice registered nurse will help develop a plan of care consistent with the patient’s own goals and priorities.
In general, we attempt to control unpleasant symptoms as much as possible while keeping the patient as functional as possible. Care with hospice includes regular medical social work guidance, as well as spiritual and grief support.
Home health aides come frequently to assist with bathing when this is needed and we provide the medications necessary for symptom management. We also provide round-the-clock registered nurse call and an on island physician on call.
As much as possible, specially trained volunteers are also enlisted to help support the patient and family. Medical equipment, oxygen, and other supplies may also be provided.
It often takes a few weeks to fully coordinate all aspects of the care plan for an individual patient, but unfortunately, many patients are not referred until the last one to three weeks of life.
Although Medicare provided the original benefit, Medicaid, and almost all private insurances now provide it. Kauai Hospice offers the same care whether there is insurance or not. Co-payments are not charged.
This is all thanks to a number of generous donors in our community and the community participation we get in events like the “Concert in the Sky” and the “Island Style Tour of Homes.”
Many people ask us if it is difficult to work with dying patients, but hospice nurses usually respond that it is an honor to help care for people in the final chapter of their lives.
During the past year, our staff has given aid to many distinguished World War II veterans, teachers who have taught our keiki for decades, farmers who have grown the cane and other crops, business and government leaders, lawyers, and even other health care professionals.
The work is not depressing. “Depressing” is when there is nothing you can do and there is almost always something we can do to relieve symptoms, allay fears and concerns, or help the caregiver. For questions regarding the Kauai Insight column, contact “mailto:rweiner@kauaihospice.org”
• Dr. Robert S. Weiner is medical director for Kauai Hospice.
