November 2014: National Hospice and Palliative Care Month
McLean Hospice Medical Director, Kevin Baran, MD, MPH, HMDC, Explains the Benefits of Hospice Care.
John was a 77-year-old patient of mine who had been battling congestive heart failure for years. His hospitalizations for trouble breathing were occurring more frequently. When I saw him in my office for a follow-up appointment, he looked exhausted. I spoke with him about his options; when I mentioned hospice care, he and his family were taken aback. They, like many people, were not very familiar with hospice care and assumed it was for imminently dying patients with cancer. As both his primary care physician and a certified hospice medical director, I educated him and his family about the choices and benefits of hospice care.
Many people associate hospice with cancer, which is common. However, non-cancer diagnoses within hospice are just as frequent and include persons with advanced stages of cardiac disease (congestive heart failure, heart disease), lung disease (emphysema, fibrosis, COPD), and neurological diseases (ALS, MS, and Alzheimer’s dementia) to name a few.
Hospice care is covered by Medicare, Medicaid, and most private insurances, for patients with a life expectancy of six months or less. Patients and family coping with serious health conditions are encouraged to discuss personal wishes and choices with the physician to determine together if and when hospice care is appropriate.
Hospice focuses on symptom management, rather than disease cure. Emphasis is placed on comfort and ease of suffering from pain and anxiety, when a patient no longer wishes to go to the hospital or pursue curative therapies. Quality and richness of life are valued and seriously considered, above all. The hospice team is specially trained to focus on the whole person and his/her family, supporting patient and family to live life as fully as possible each day along the final journey.
Hospice care is provided wherever the person lives, in a private home, apartment, assisted living, or nursing home. Sometimes hospice care is provided short term in a hospital wing or special facility to bring symptoms under control. The benefits of hospice include a multi-disciplinary approach to the patient’s care. This includes visits by professional nurses, home health aides, spiritual counselors, medical social workers, and volunteers. There are also special hospice pharmacy services, all under physician direction. Comforts may also include alternative therapies such as music therapy, Reiki, massage, or pet therapy.
After speaking with his family, his cardiologist, and me, John chose at-home hospice care. His hospice nurse helped me adjust his medications to improve his breathing comfort. Home health aides helped with bathing and dressing a few hours a week. Volunteers helped John create a book of memories for his family, and kept him company in order for his family to run errands. The hospice medical social worker arranged for a few days of respite for family to take a brief vacation. A spiritual counselor helped John and his wife explore what gave meaning and purpose to John’s life. Five months later, John passed away peacefully at home with his family by his side. A hospice nurse arrived to help with final preparations. She also arranged for the family to receive the support of the hospice bereavement program over the next year.
About Dr. Baran: Kevin M. Baran, MD, MPH, HMDC has served as the Hospice Medical Director at McLean Home Care and Hospice since 2011. He earned a BS from Tufts University in Biology and Spanish. He continued his graduate education in medicine and public health at the University of Connecticut School of Medicine. Dr. Baran then traveled to Peru for his fieldwork, where he worked with local communities along the Amazon River. He completed his internship and residency at Yale University.
Dr. Baran was selected to be a National Health Service Corps Scholar and has received numerous honors and recognitions during his clinical career, including being awarded for his competency in diabetes care leadership. He is certified in Internal Medicine and is a member of the American Academy of Hospice and Palliative Medicine, the American College of Physicians and the National Physicians Alliance. He is among the first in the nation to earn the new Hospice Medical Director Certification, HMDC. Dr. Baran is part of ProHealth Physicians and his private office is located in Plainville, CT.
For more information on the McLean Hospice Program, please call 860-658-3700, of visit McLeanCare.org.
McLean is a not-for-profit senior living community in Simsbury, CT offering a continuum of services including independent living, assisted living, and memory care assisted living; an adult day program, short- and long-term skilled nursing, outpatient rehabilitation and wellness; post-acute care, home care and hospice.