Hospice Care Guide for East Texas and The Golden Triangle Region

Who is Eligible for Hospice Care?

When you’re looking for Beaumont senior medical and health information, SETX Seniors is here to help.

Today we look at eligibility for hospice care in Southeast Texas.

Southeast Texas Hospice Care has grown significantly over the last two decades. This has led to more and more requests from Beaumont seniors about hospice care- what hospice care is, what hospice care offers, and who is eligible for hospice.

Today on SETXseniors.com, we’re working to answer that last questions for Southeast Texas seniors – Who is eligible for hospice care?

Often when a loved one receives a terminal prognosis from a physician, Hospice care is discussed. 

Many Southeast Texas senior citizens are understandably uncertain whether they or a loved one is eligible for Hospice.

Southeast Texas’ own Harbor Hospice provides useful reference guidelines for helping Southeast Texans determine whether or not they are eligible for Hospice care.

Guidelines in determining patient eligibility under the Medicare/Medicaid Hospice Benefit are helpful by identifying those persons that may have a life expectancy of approximately six months or less. A patient will need to meet all of the following criteria to be eligible for hospice:

• The patient’s condition is life limiting, and the patient and/or family has been informed of this determination. A “life limiting condition” may be due to a specific diagnosis, a combination of diseases, or there may be no specific diagnosis defined.
• The patient and/or family has elected treatment goals directed toward relief of symptoms rather than cure of the underlying disease.
• The patient has one of the following:

1. Documented clinical progression of a disease, which may include:
   1. Progression of the primary disease process as listed in disease-specific criteria and documented by a physician assessment, laboratory, radiology, or other studies.
   2. Multiple Emergency Department visits or inpatient hospitalizations over the prior six months.
   3. For Homebound patients receiving home health services, nursing assessment may be documented. For patients who do not qualify under 1, 2, or 3, a recent decline in functional status may be documented.
   4. Documented recent impairment of nutritional status relating to the terminal process.
      1. Unintentional, progressive weight loss of greater than 10% over the prior six months.
      2. Serum Albumin less than 2.5 gm/dl may be a helpful prognostic indicator, but should not be used in isolation from other factors in factors I-III above.

Coverage of Southeast Texas hospice care depends upon a physician’s certification that a person’s life expectancy is six months or less if the illness runs its normal course. Recognizing that determination of life expectancy during the course of a terminal illness is difficult, the National Hospice and Palliative Care Organization has published medical criteria for determining prognosis of certain diagnoses.

These guidelines form a reasonable approach to the determination of life expectancy based on available research.

If a Southeast Texas senior meets the medical criteria, they are, by definition, eligible to receive hospice services. Some Beaumont seniors may not meet the above outlined criteria, but may still be eligible for hospice care because of other co-morbidities or rapid functional decline. It is the physician’s clinical judgment regarding the normal course of the individual’s illness which determines a prognosis of six months or fewer.

If you have further questions for yourself or a special Beaumont senior in your life, your senior care doctor can help you get answers, information, and a better understanding of Hospice care and the eligibility of you or a loved one for Southeast Texas Hospice care.

We hope today’s article has been helpful.

SETX Seniors works hard to help you find the Southeast Texas senior medical information you need.

With over 400 articles a year on topics ranging from senior exercise opportunities to Southeast Texas home health and hospice agencies, we are your go to resource for Southeast Texas senior news online.

• Daryl Fant, Publisher Senior Resource Guide

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