Hospice Care Guide - Questions & Answers - Part One

Pathways will be sharing the answers to some of the most commonly asked questions regarding hospice care beginning this week.  

We're Here to Help

We know that when it is time to think about hospice care, you need your questions answered.

Most of us have little first-hand knowledge of hospice, and need facts to make the best possible health care decisions.  Here we’ll tell you about hospice care, and answer some of the common questions that people ask. 

We welcome your call if you have more questions or would like to schedule an informational visit.

Call Pathways toll-free at 1.888.755.7855.

What is Hospice?

In the United States, hospice is a kind of care, not a place.  Hospice is provided wherever you live.  It is specialized care for people whose doctors believe they probably have six months or less to live. 

People nearing the end of life often have many changes happening in a short period of time.  There may be changes in medications, sleep habits, fatigue, diet, and family roles, to name just a few.  It is the job of hospice to address each of these changes as they occur, to make the quality of life the best it can be. 

Who pays for hospice?

Hospice is a benefit covered under Medicare, Medi-Cal, senior HMOs, regular HMOs and private insurance.  Hospice pays for all medications, medical equipment and supplies that are related to the life-ending disease.

Is hospice care just for people with cancer?

No.  Most patients on hospice do not have cancer.  They may have emphysema, Alzheimer’s, heart failure, kidney disease, Parkinson’s, or any of many other diseases.  Some people do not have a certain disease, but seem to be declining from old age.

How can I manage to care for my loved one at home?

Hospice nurses and other team members provide care during their visits, and they will teach you what you need to know to provide care at home. 

Who comes to visit us?  

Hospice care is provided by a team.  Each patient has a nurse case manager.  You can decide if you would also like a hospice aide to give personal care, a spiritual care counselor to talk to, a social worker to assist with arranging practical matters, or a volunteer to run errands or keep the patient company. 

Be sure to check back in with us next week for the next part of our blog series on commonly asked hospice questions and answers.  

At the end of the blog series we will post a downloadable PDF with all of the questions and answers covered in this blog.

Great Catheter Care: Preventing Infections

Good catheter care is the biggest factor in preventing catheter-associated urinary tract infections.  Here are some tips for great catheter care.

• Wash your hands.  It sounds simple, but this is the single most important step in preventing infections.  Wash your hands BEFORE and AFTER putting on gloves.
• Use catheters sparingly—only when necessary.
• Use the smallest catheter that will do the job.
• When inserting the catheter, lay out a sterile field and maintain it.  If a person is obese or has contractures you may need two people to insert the catheter while maintaining a sterile field.
• Lubricate the tip of the catheter to prevent damage to the urethra during insertion.
• Use good lighting.  If you accidentally insert the catheter in the vagina, leave it there as a marker until you have placed a second, sterile catheter.
• Keep the system (catheter, tubing and bag) closed if possible.  The system should never be opened simply for convenience.
• Keep the drainage bag below the level of the bladder (but not lying on the floor).  Use clean technique when emptying the bag.
• Secure the catheter to prevent bleeding, trauma, tissue damage or bladder spasms that can be triggered by the catheter or balloon.  Tape can be hard on the skin; use a commercial device when possible.
• Keep the perineum clean.  Treat the catheter area like any other part of the body, washing as you would any other body part.
• If the resident is also incontinent of stool, check frequently to prevent stool from contaminating the catheter.
• Keep residents with catheters away from residents with infections.

Suspected infection:

If you suspect a urinary tract infection, remove the catheter and replace it with a new one.  Get a urine sample for culture and sensitivity from the new catheter.  Antibiotics should only be used for infections that are symptomatic.

Leakage

If catheter leakage occurs, check that the balloon is inflated and that the catheter is in the right place.  Make sure the balloon is inflated completely.  It is never acceptable to use a 30 cc balloon partially inflated.  Before changing to a larger catheter, keep in mind that constipation and fecal impaction may also contribute to leakage.  Larger catheters with larger balloons can damage the neck of the bladder.

YOU are the key to good catheter care that can prevent infections and discomfort, and save time and money.