Patients & Families

Advanced Directives

How would you like to be treated if you are terminally ill?  Decisions like these are best made before there is a terminal diagnosis.  An important decision that you might not have  thought about is your decision for health care in the future.  Planning ahead for this now, while you are still able, is a gift you can give to yourself and the ones you love.  Having a plan in place will make it easier for you, your doctor and your loved ones if decisions about your treatment ever need to be made and you are unable to do so at that time.

South Carolina Law provides several documents:

Health Care Power of Attorney: This legal document allows you to designate someone to make healthcare decisions on your behalf if you are temporarily or permanently unable to do so.

South Carolina Heath Care Power Of Attorney Form

Living Will (Declaration of a Desire for a Natural Death): Allows you to put in writing your choices about your care ONLY if you are terminally ill or permanently unconscious.

South Carolina Living Will Form

Living wills include your choices for the following:

  • Pain relief
  • Antibiotics
  • Hydration
  • Feeding
  • Use of ventilators
  • Cardiopulmonary resuscitation
  • Life sustaining measures

Make sure that your loved ones and health care providers have a copy of your living will.

Five Wishes: This legal document combines a health care power of attorney and a living will and allows you to express your wishes for not only medical needs, but for personal, emotional and spiritual needs as well.

Five Wishes allows you to indicate:

  • Who you want to make health care decisions for you when you can’t voice them yourself
  • Which medical treatment you want and do not want
  • How comfortable you want to be
  • How your family members and others treat you
  • What you want your loved ones to know about your conditions

This form can be accessed online or printed for your convenience at agingwithdignity.org.In South Carolina, this document must be witnessed and notarized.

Decisions about end-of-life care are deeply personal and are based on your values and beliefs.  Because it is impossible to foresee every type of circumstance or illness, it is essential to think in general about what is important to you. Above all, advance care planning conversation will settle any concern and make your care going forward as clear as possible.

FAQ

What is hospice?
Hospice is a model of holistic health care designed to treat the whole person so he or she may live fully, maintain dignity and retain personal control. This concept of care provides physical, emotional and spiritual care to patients and their families living with a life-limiting illness.

When is the right time to call Piedmont Hospice?
Any time during a life-limiting illness, it is appropriate to discuss all of a patient’s care options, including hospice. The earlier Piedmont Hospice is involved, the more beneficial it can be for a patient and their family.

  • It is time to call Piedmont Hospice when…
  • Curative treatment is not an option
  • When the goal of care changes to comfort, symptom control and enhancing the quality of life
  • A physician feels Piedmont Hospice’s services could help

Who qualifies for hospice care?
Hospice care is for anyone who has a life-limiting or terminal illness with a prognosis of six months or less if the illness runs its normal course. Patients with both cancer and non-cancer illness are eligible for hospice care.

How are Piedmont Hospice’s services initiated?
A physician (or other health care professional), a patient or designated health care surrogate may request Piedmont Hospice services.  Ultimately the patient and the primary care physician must agree that the referral is appropriate and approve admission to hospice. Hospice care is established when the patient, primary caregiver or health care representative agree with the hospice terms in written form.  A plan of care is established and subsequent visits by the hospice team are scheduled.

Where is care provided?
Care is provided in a setting that best suits the needs of the patient and caregivers. It may be provided at home, the home of a caregiver or at an inpatient facility.

How much will hospice cost me?
Hospice coverage is provided by Medicare, Medicaid and by most private health insurance policies. Medicare and/or Medicaid are the most frequent sources of payment. Both will pay at 100% for medication, personal hygiene items and medical supplies relating to the terminal diagnosis, equipment needed for comfort and safety (hospital bed, bedside commode, wheelchair, etc) and the services of the hospice team.

Piedmont Hospice assesses patients based on need and not financial status. No patient will be refused care based on inability to pay. Eighty percent of people who use hospice care are over the age of 65 and therefore are entitled to the Medicare Hospice Benefit.  As a result, the financial burdens usually associated with caring for terminally ill patients is virtually non-existent. For patients without a payer source, Piedmont Hospice will conduct a financial assessment based on a sliding fee scale.

What does hospice service cover?

  • Physician services for the medical management of the patient’s care
  • Regular home visits by skilled nurses
  • Certified Nurse Aides for personal grooming and assisting with meals
  • Social work and counseling
  • Medical equipment
  • Medication related to the patient’s diagnosis and symptom management
  • Medical supplies and personal hygiene items
  • Volunteer support for companionship
  • Physical therapy, speech therapy, occupational therapy and dietary counseling as needed

Who takes care of hospice patients?
The Piedmont Hospice Team is composed of compassionate professionals who address the physical, emotional, mental and spiritual needs of patients:

  • The Patient’s Personal Physician may continue to direct the patient’s care alongside other members of the hospice team.
  • The Hospice Medical Director is a physician specially trained in pain and symptom management as well as other issues involved with treating life-limiting illness.
  • Registered Nurses have advanced training and provide comprehensive nursing services in the home. On-call staff is available 24 hours a day, 7 days a week, 365 days a year as needed.
  • Nursing assistants are trained to provide personal care in the home in a respectful and professional manner that promotes dignity for the patient.
  • Medical Social Workers have advanced education in counseling and are trained to help individuals and families cope with emotional, social and financial stress due to life-limiting illness and impending loss.
  • The Hospice Chaplain is a minister who provides spiritual care and counseling if requested.  Care is non-denominational and does not impose any particular theology or religion, but addresses spiritual concerns regarding death and dying.
  • The Hospice Bereavement Counselor provides specialized grief support to families following the loss of a loved one. Support groups, reading materials and individual counseling can continue for up to thirteen months.
  • All of our Volunteers have completed an intense training program preparing them to help patients and family with practical needs such as running errands and companionship.

What are the service areas for Piedmont Hospice?
Piedmont Hospice is proud to be serving patients and families from three locations in South Carolina.  The Lowcountry office services Berkeley, Charleston, Colleton and Dorchester counties.  The Upstate office services Anderson, Cherokee, Greenville, Laurens, Oconee, Pickens, Spartanburg, Union and York counties. Our dedicated hospice teams live in your communities and are readily available to provide services whenever the need arises.  Contact us HERE for more information.

Grief Support

At Piedmont Hospice, bereavement care is an integral part of our plan of care for both families prior to and after the passing of a loved one. Grief and mourning are an integral part of the healing process for a spouse, family member or friend after the loss of a loved one. The Bereavement Program at Piedmont Hospice is available to help individuals through the healing process. The program continues for up to 13 months after the passing of a loved one and helps family and friends deal with the feelings of sadness, loss and grief.  We understand there is never enough time to prepare for a loss, but with support, time to grieve, patience and effort, there can be acceptance.

UNDERSTANDING YOUR FEELINGS OF GRIEF
Grief is a normal reaction to loss that can literally turn your world upside down.  Your emotions, thought processes, behaviors and physical well-being are all affected by grief.  Most people who suffer a loss typically experience one or more of the following reactions:

  • Anger or increased irritability
  • Frustration or annoyance
  • Guilt
  • Anxiety
  • Depression
  • Fatigue
  • Confusion
  • Inability to concentrate
  • Change in appetite – eating more or losing appetite
  • Sleep disturbances – sleeping too much or not at all
  • Physical complaints
  • Sudden mood swings
  • Lack of energy

There is no “time limit” for resolving feelings of grief.  Everyone goes through the grief process at his or her own pace and it’s important to have realistic expectations about the various reactions you will experience.   For example, you can expect that:

  • Your grief will take more energy than you would have ever imagined.
  • Your grief will involve many changes and will be continually developing.
  • Your grief will show itself in all spheres of life; psychological, social and physical.
  • Your grief will depend upon how you perceive your loss.
  • You will grieve for what you have lost already and for what you have lost for the future.
  • Your grief will entail mourning – not only for the person you lost – but for all the hopes, dreams and unfulfilled expectations you held for and with that person, and for the needs that will go unmet because of his or her death.
  • Your loss will resurrect old issues, feelings and unresolved conflicts from the past.
  • You will have some identity confusion, not only as a result of the loss, but also because you are experiencing reactions that might be quite different for you.
  • You may have a combination of anger and depression that result in irritability, frustration, annoyance or intolerance.
  • You will feel some anger and guilt, or at least some manifestations of these emotions.
  • You may have a lack of self-concern.
  • It is normal to feel suicidal; fantasizing about a reunion with your loved one can help you cope, but you should get help if you are concerned or make concrete suicide plans.
  • You may experience grief spasms (acute upsurge of grief) that occur suddenly, with no warning.
  • You will have trouble thinking and making decisions due to memory, organization and intellectual processing issues.
  • You may be obsessed with death or preoccupied with the deceased.
  • You may begin a search for meaning and may question your religion and/or philosophy of life.
  • You may find yourself acting socially in ways that are different from before.
  • You may find yourself having a number of physical reactions.
  • You will find that society will have unrealistic expectations about your mourning and may respond inappropriately to you.
  • You may find that there are certain dates, events and stimuli that bring upsurges in your grief.
  • Certain experiences in later life may resurrect intense grief for you temporarily.

Your grief may bring with it an intense amount of emotion that will surprise you and those around you.  It will not only be more intense than you expected, but will also be manifested in more areas and ways than you ever anticipated.  Your individual experience will depend upon the social support and your physical state.

More often than not, those who are grieving receive insufficient assistance from friends and society.  Piedmont Hospice has set in place various bereavement services to assist after the loss of a loved one.

BEREAVEMENT COORDINATOR
The Bereavement Coordinator calls or visits families to identify bereavement needs.  The Coordinator is available before and after the passing of a loved one.  Our bereavement coordinators are specifically trained and experienced in the process of grief and loss.

TRAINED VOLUNTEERS
Emotional support may be provided by trained volunteers through monthly phone calls, visits and assisting with family needs.  Volunteers are available to listen to families and friends in need of companionship.

HOSPICE MEMORIAL SERVICES
Services are a celebration of life for families to remember their family member, reconnect with the hospice team and reflect.  Memorial services are a time to celebrate the life  of a loved one and remember them through liturgy, scripture, song, music and reflection.  Families and friends are invited to attend.  The name of hospice patients are read during the services and families and friends are invited to release a butterfly or dove in remembrance of their loved one.

SUPPORT GROUPS
Monthly support groups provide an opportunity for mutual sharing and support.  Those who have suffered a loss have an opportunity to discuss their feelings and changes the loss has brought to their lives.  Participants can share coping methods for dealing with emotions and get reassurance that they are not alone in their loss.

For more information about our bereavement program or to speak with someone about bereavement care, call the Upstate office at 864.721.2900 or the Lowcountry office at 843.766.3331.