Resource Library

How Much Does Hospice Cost?

Hospice of the Valleys is a local, community-based, nonprofit hospice. We are a Medicare certified hospice and accept Medicare/Medi-Cal and most private insurance plans. If you have Medicare insurance, whether it is straight Medicare, HMO or PPO Medicare plans, your hospice care will be 100% covered under the Medicare Hospice Benefit. Hospice care is provided to the patient where they live, whether that is in their home, nursing home, board and care or assisted living.

For those who do not have Medicare we accept most insurance policies. Our list includes, but is not limited to:

  • Blue Cross of California
  • Blue Shield of California
  • GrayBill Medical Group
  • IEHP
  • Health Net of California
  • Medicare
  • Medi-Cal
  • OptumHealth Care Solutions, Inc.
  • PrimeCare Medical Network, Inc.
  • Regal Medical Group, Inc.
  • SCAN
  • Sharp Community Medical Group
  • UnitedHealthcare
  • UnitedHealthcare Military and Veterans Tricare
  • Valley Physicians Network

We are happy to help by contacting your insurance carrier to coordinate your hospice benefit.

Thanks to the generous support from our community, we do not deny care for those due to lack of insurance or inability to pay.

Medicare covers hospice services such as:

  • Hospice physician services
  • Nursing care
  • Medical equipment
  • Medical supplies
  • Drugs for managing symptoms & controlling pain
  • Home health aide services
  • Medical social workers
  • Grief support for patients and families
  • Chaplains & spiritual care providers
  • Volunteers
  • Link to Medicare hospice benefit: https://www.medicare.gov/Pubs/pdf/02154-Medicare-Hospice-Benefits.PDF

As a trusted member of our community, Hospice of the Valleys, a nonprofit 501(c)(3) has been providing hospice care to the Inland Valley and Fallbrook for 35 years. Thanks to the generous support from our community, in the form of donations, memorials, fundraising, grants, and bequests to support our mission to provide excellent care to the community, we do not deny care for those due to lack of insurance or inability to pay.

Please give us a call, we’re here to help. 951-200-7800.

Questions To Ask When Interviewing A Hospice

  1. Where is the hospice headquartered and how long have they been providing hospice care?     Hospice of the Valleys is headquartered in Murrieta, California and has been providing hospice care to our community for 35 years. Our staff lives in our service area, which allows us to respond quickly to the needs of our patients.
  1. Is your hospice for profit or nonprofit?     Hospice of the Valleys is a nonprofit hospice governed by volunteer board members from our community. As a non-profit we are committed to our mission: We foster reverence for life, relief of suffering, and compassion in loss for the terminally ill residents and their families in the communities we serve.
  1. How many patients does each Case Manager, RN care for?     Our goal is for each Case Manager, RN to care for approximately 12 patients at any given time.
  1. Does your hospice physician work exclusively for your hospice or is your doctor responsible for hospital and/or patients in a clinic setting?     Hospice of the Valleys Executive Medical Director, Leslee Cochrane MD, is a Family Practice physician by background and is Board Certified in Hospice and Palliative Care. Stephen Ryder MD, is an Internal Medicine physician by background and has been providing hospice care for over 10 years. Both are solely dedicated to serving and caring for the patients of Hospice of the Valleys.
  1. Can I speak with your hospice physician via phone prior to admission?     Our physicians are always available via telephone to the patient or family during the admission process.
  1. What percentage of patient families reported to the Medicare survey, Hospice Experience of Care,* that they always received timely patient care?     9% of Hospice of the Valleys patient families reported to the Medicare survey, Hospice Experience of Care* that they always received timely care.
  1. What percentage of patient families reported to the Medicare survey, Hospice Experience of Care,* that they would definitely recommend the hospice they had used?     96.6% of Hospice of the Valleys patient families reported to the Medicare survey, Hospice Experience of Care,* that they would definitely recommend Hospice of the Valleys.

 

*Hospice Experience of Care is a survey that Medicare sends to every family that has had a loved one on hospice care.

What Services Does Hospice Provide?

What do you do, when you learn that a family member’s medical condition will not improve? There is no cure, treatments are no longer effective, and normally simple aspects of daily life become more complicated. You face challenges every day, in order to accomplish things most people take for granted, and it can be difficult to know where to turn.

For example, how does your loved one, who might suffer from limited mobility, get to the doctor’s office? Hospice solves this problem by sending nurses to regularly visit your loved one in their own home, and by arranging for a doctor to make house calls. Healthcare comes to the patient, making life easier for both you and your loved one.

Then there are the issues that you don’t think about, until a serious illness or disability strikes. How will you get medications or special equipment? Hospice care arranges all of that for you. Prescriptions are ordered and delivered to your loved one in a timely manner. The need for special equipment, such as oxygen or hospital beds, is anticipated. Those items are ordered and delivered for you. Hospice offers overall medical management, so that you don’t have to piece together services, medications, equpiment and appointments on your own.

However, Hospice also offers support to you, the primary caregiver, and your family members. If you have a question or concern, someone is always available by phone. If Hospice can’t answer your question, a nurse is dispatched to check on your loved one. Hospice also provide emotional and spiritual support during this difficult time, and a full year of bereavement support to your family when that time comes.

Hospice offers a full range of services, provided by knowledgeable, experienced professionals who truly care about their patients and families. For more information on the specific services provided by Hospice care, call us and we will be happy to explain how the process works. Or, watch our video below for a more in-depth explanation.

What Services Does Hospice Provide? from Hospice of the Valleys on Vimeo.

Symptoms of Dementia Might Vary According to Type

When you think of dementia, Alzheimer’s disease probably leaps to mind. After all, 8 out of 10 patients with dementia do indeed present with Alzheimer’s. However, there are other types of dementia that can strike as we age, and the progression of the disease might different significantly from Alzheimer’s.

Remember that when we talk about dementia, we are talking about a physical disease of the brain. Therefore, presentation of symptoms will depend upon actual changes in the brain’s physical structure or functioning.

Alzheimer’s has been linked to an abnormal protein, which creates a plaque buildup in the brain. The disease progresses gradually, and each patient will pass through very predictable stages as they age.

Another type of dementia, called vascular dementia, originates from a different type of malfunction. The small blood vessels which feed the brain begin to plug up and become blocked, causing a reaction similar to a very small stroke. However, we are talking about microscopic blood vessels in this case, not the large ones affected by strokes. So vascular dementia can present with very few symptoms for a long time, and then a series of events in the brain can trigger a more sudden decline.

Whereas Alzheimer’s patients experience a predictable path of deterioration, vascular dementia patients can present with uneven symptoms. Language is often preserved while other functions decline. This can lead to patients expressing a desire to be independent and care for themselves, yet being physically unable to actually do so.

As you can see, the type of dementia experienced by the patient can greatly impact the type care they need. For more information on the different types of dementia, check out our video below, and give us a call if you have questions about caregiving at this stage in life.

Dementia: Most Common Types from Hospice of the Valleys on Vimeo.

The Truth About Dementia

You probably understand that heart disease is a disease of the heart. There is something physically wrong, caused by a combination of genetics, environment, and lifestyle, that damages a person’s heart and causes it to become unhealthy.

Like heart disease, dementia is also a degenerative disease. Yet, most people believe that dementia is a mental illness, like depression or anxiety. This is a common misconception, and researchers are discovering more and more how very wrong it is. Dementia is actually a disease of the brain.

Thanks to modern imaging technology, we can clearly see structural abnormalities in the brain. In the case of dementia, researchers have even been able to track the progression of the disease through a series of scans.

When a person with dementia exhibits symptoms, such as forgetfulness and confusion, you are seeing the results of changes in brain function.

Imagine that you have a piece of yarn, and you want to wind it into a ball. As you do this, you start with a very small ball that gradually becomes larger. Now picture that small, initial ball of yarn as the basic functions you learned when you were a small child. You learned how to eat, communicate through crying, and so on. Later we learn to walk, smile, feed ourselves, go to the bathroom, talk, and gradually develop more complex skills.

The progression of dementia is like unwinding that ball of yarn. At first the patient loses more complex skills, but as the disease progresses they lose more basic, life-sustaining abilities.

That idea, and more, is explained in the brief video below.

Dementia: The Big Misconception from Hospice of the Valleys on Vimeo.

The Power of Planning (Wills and Trusts)

We’ve all heard stories of bereaved relatives, surprised by a strange Last Will and Testament scribbled on a sheet of notebook paper, tucked into a random drawer somewhere in the house. Over the years, these stories surface to amuse us (due to the lack of planning and surprise of relatives who discover they have inherited small fortunes) or to warn us (in the case of contested estates that are hung up in court for years).

There is really no need to neglect these aspects of estate planning. It’s easy enough to meet up with an attorney, discuss your wishes, and draw up the appropriate legal documents. Doing so will give you peace of mind, knowing that your assets will be distributed according to your wishes. You might also be comforted to know that your loved ones will avoid a long, difficult legal ordeal.

One of the first decisions you will make, with regard to estate planning, is whether to establish a Will or a Trust. The primary difference between the two is that a Will takes effect upon your death, while a Trust begins on the day you create it.

With a Will, you leave directions for the distribution of assets after your death. For example, you might want to leave your bank accounts to your spouse, your beach house to the children, and various items to friends or other relatives. After your death, these assets will be distributed as directed. You might also wish to leave instructions for your burial, designate guardianship for children or pets, and state other final wishes.

A Trust, on the other hand, can be used to distribute property before your death, after death, or at some other point in the future. A trustee (a bank, law firm, or other organization) holds legal title to property placed in the trust. The beneficiaries of your choosing can receive income from that trust, or the entirety of the property at a time of your choosing.

So should you choose a Will or a Trust? That depends upon many factors, but consider this: A Will passes through probate, with a court ensuring that the Will is valid, and then overseeing the administration of the document. A Trust is not subject to the probate process, so your assets can pass directly to heirs while bypassing the complicated, difficult court procedures. A Trust can also be kept private, whereas everything that passes through probate court will be part of public records.

Wills and Trusts each come with distinct advantages and disadvantages, and there is no single solution that is right for everyone. Discuss your needs and concerns with an estate planning attorney, and he or she can help guide you toward the legal process that suits your situation.

Join us on March 15th at the Temecula Valley Hospital from 6-8pm for a screening of the PBS Frontline Documentary “Being Mortal”. This documentary is based on the end of life experiences of several patients and addresses the importance of talking about end-of-life care goals with your family and medical providers.

Following the film we will have a Q&A session led by Laurence Boggeln, Chief of Staff of Temecula Valley Hospital and Leslee B. Cochrane, MD., Executive Medical Director for Hospice of the Valleys who will be available to interact with the audience and answer questions. During the event we will also be distributing a complimentary copy of “Five Wishes” to attendees. “Five Wishes” is a living will, valid under California state law that talks about your personal, emotional and spiritual needs, as well as your medical wishes. The do-it-yourself format is simple and easy to use and enables you to complete your Health Care Directive   in the privacy of your own home

For more information please visit Hospice of the Valleys’ website at www.HospiceoftheValleys.org for future screenings.

 

The Power of a Power of Attorney

Establishing a Power of Attorney can be a confusing process, but creating this legal document is essential to ensure that your future medical care will fall in line with your wishes. Once you have chosen a trusted relative or friend to entrust with your future decisions, you might be wondering exactly what this person will and will not be doing.

Two Types of Power of Attorney

First, it’s important to understand that there are two types of Power of Attorney. A healthcare Power of Attorney is able to make medical decisions for you, in the event that you are ever unable to do so yourself. This person should be educated on your wishes regarding various types of medical treatment and life-prolonging care. He or she might also make decisions about where you live and how you receive daily care. You can also outline these wishes in legal documents, if you choose.

You can also establish a financial Power of Attorney. This person can manage your financial decisions and transactions for you, in the event that you are medically incapacitated. This person will make sure that your bills are paid, can file your taxes for you, and make decisions about investments.

You can designate the same person for both of these tasks. Or, you might wish to avoid a conflict of interests, or feel that two different people possess the right type of insight for each job. In that case you can appoint one person as your financial Power of Attorney, and another person as your healthcare Power of Attorney.

What a Power of Attorney Can’t Do

A financial Power of Attorney can indeed access your financial accounts, pay your bills, and perform transactions. However, they can only use their status to perform actions that you have directed to them. If at any point you suspect your financial Power of Attorney of a misdeed, or feel that they are no longer the right person for the job, the status is revocable.

A healthcare Power of Attorney can feel a bit of pressure when making major end-of-life decisions. That’s why a living will can be important. In the living will, you can state your preferences for medical care. This not only ensures that your wishes will be followed, but also prevents feelings of distress and regret for your Power of Attorney. He or she will be compelled to follow your directions.

It is imperative that you discuss your concerns in detail with an estate planning attorney. He or she can help you understand the various issues involved with naming a Power of Attorney, and ease you through this difficult process.

Join us on March 15th at the Temecula Valley Hospital from 6-8pm for a screening of the PBS Frontline Documentary “Being Mortal”. This documentary is based on the end of life experiences of several patients and addresses the importance of talking about end-of-life care goals with your family and medical providers.

Following the film we will have a Q&A session led by Laurence Boggeln, Chief of Staff of Temecula Valley Hospital and Leslee B. Cochrane, MD., Executive Medical Director for Hospice of the Valleys who will be available to interact with the audience and answer questions. During the event we will also be distributing a complimentary copy of “Five Wishes” to attendees. “Five Wishes” is a living will, valid under California state law that talks about your personal, emotional and spiritual needs, as well as your medical wishes. The do-it-yourself format is simple and easy to use and enables you to complete your Health Care Directive   in the privacy of your own home

For more information please visit Hospice of the Valleys’ website at www.HospiceoftheValleys.org for future screenings.

 

 

The Importance of a Health Care Directive

Even though death is a very natural, inevitable part of life, we are often reluctant to think about it. Due to that reluctance, many of us fail to plan for end-of life issues. However, leaving everything up in the air is a big risk to take! If you take the time to prepare an Advance Health Care Directive now, you can ensure that your future medical care is in line with your values and preferences.

An Advance Health Care Directive is a legal document that provides your doctor and loved ones with instructions for your care, in the event that you are unable to communicate your own wishes at some point. It will only take effect under the conditions you outline in the document, so you don’t need to worry about it ever superseding your wishes.

Appoint a Durable Power of Attorney for Health Care. Your Advance Health Care Directive gives you the opportunity to appoint a Durable Power of Attorney for Health Care, also called a Health Care Proxy, who will have the legal authority to make health care decisions for you. Many people name their spouse; however, you should also consider a back-up proxy just in case you and your spouse become ill around the same time.

Provide specific instructions for your health care. There is no need to simply hand over the authority to make decisions for you, though. Your Advance Health Care Directive allows you to state in clear, medical terms which types of life-prolonging treatments you do and do not want to receive. You may also state your wishes regarding pain relief, organ donation, and many other important medical issues. Your proxy will communicate these preferences to your medical team, and ensure that they are carried out.

An Advance Health Care Directive can prevent disputes during an already difficult time, and provide your loved ones with peace of mind knowing that they made the decisions you would have wanted.  Remember: If at any point your wishes change, you are certainly allowed to alter your documents.

If you are interested in learning more about completing an Advance Health Care Directive please plan to join us on March 15th at the Temecula Valley Hospital from 6-8pm for a screening of the PBS Frontline Documentary “Being Mortal”.  This documentary is based on the end of life experiences of several patients and addresses the importance of talking about end-of-life care goals with your family and medical providers.

Following the film we will have a Q&A session led by Laurence Boggeln, Chief of Staff of Temecula Valley Hospital and Leslee B. Cochrane, MD., Executive Medical Director for Hospice of the Valleys who will be available to interact with the audience and answer questions. During the event we will also be distributing a complimentary copy of “Five Wishes” to attendees. “Five Wishes” is a living will, valid under California state law that talks about your personal, emotional and spiritual needs, as well as your medical wishes. The do-it-yourself format is simple and easy to use and enables you to complete your Advance Health Care Directive in the privacy of your own home

For more information please visit Hospice of the Valleys’ website at www.HospiceoftheValleys.org for future screenings.

7 Tips to Prepare for a Productive Check-Up

Most Medicare and Medi-Cal patients are eligible for free annual wellness exams. These check-ups are important, as health conditions that are detected early are usually much easier to treat. Plus, seeking regular preventive care can actually help to ward off the development of many serious diseases.

It’s important to take your loved one to the doctor for regular checkups. But these visits will be even more productive if you can follow this handy checklist.

Create a list of all medications and dosages. If your loved one has been seeing several doctors, his or her primary care physician might not be aware of all prescription medications. Prepare this list and take it with you, just in case. It will be much easier to answer questions during this part of the checkup, and having this information can help to prevent dangerous drug interactions. Note: Include herbal remedies on this list, too. Some of them can interact with prescriptions.

Make a list of questions or concerns before you go. It can be difficult to remember everything during an office visit, so if you have multiple concerns, write them down ahead of time. Consider your loved one’s diet, sleeping habits, and any new or unexplained symptoms when making this list. If you feel that a prescription is not working well, or your loved one has developed a need for certain equipment, make a note of it.

Ask about vaccinations. If you have any concerns about vaccinations, now is the time to ask. Most doctors recommend annual flu vaccines for seniors (who are most vulnerable to the flu). You might also consider shots for pneumonia and shingles.

Schedule preventive care. Physicians generally recommend screenings for breast cancer (for female patients), colon cancer, and prostate cancer (for men). Depending upon other test results, you loved one’s doctor might also recommend screening for lipid disorder and diabetes. A bone density scan could be performed on anyone, but is mostly necessary for women over 65. At older ages, many of these tests are ordered annually. You might prefer to spread them out over a few months, if there are no pressing concerns, so that your loved one is not overwhelmed with doctor appointments.

Ask about referrals. If you’re concerned about your loved one’s vision, hearing, mental health, or some other condition which requires a specialist, ask for a referral at this visit. If your loved one smokes, now is the time to ask about smoking cessation programs.

Make your own record. Write down your loved one’s height, weight, blood pressure, blood sugar, and the results of any other test performed at the check-up. These can be handy in an emergency. Also, write down the lot numbers of any vaccines received, along with the date. If your loved one experiences a reaction to a vaccine, you will need this information to make a report.

Schedule something fun or relaxing afterward. Your loved one might be feeling anxious or stressed from the doctor visit. Depending upon his or her preferences and energy level, you might wish to schedule something fun (like dining out) or relaxing (a spa visit) afterward.

The above tips are just a general guideline for a successful checkup. Your loved one’s physician may have additional concerns, depending upon his or her individual condition and needs.

As a trusted member of our community, Hospice of the Valleys, a nonprofit 501(c)(3) has been providing hospice care to the Inland Valley and Fallbrook for over 34 years. Please call us for senior community resources, or for information about hospice care. We’re here to help. 951-200-7800.

How to Keep Your Loved One Safe at Home

If you’re caring for an older loved one, you might be undertaking this task in their home, or in yours. Either way, it is likely that the house is not already set up for caretaking duties of this magnitude. The design of most homes does not take into account the tasks and responsibilities you face on a daily basis.

So take a second look at the rooms where your loved one spends most of their time (the living room, their bedroom, bathroom, and hallways). You might need to make some changes to keep him or her safe, and make your days run a bit more smoothly.

In the bathroom:

  • How high is the toilet? A raised toilet can help a lot with comfort, as well as aid independence
  • Consider installing handrails so that your loved one can get up and down from the toilet more comfortably
  • Purchase nonskid mats for the floor and shower stall
  • Install a special seat in the shower for easier bathing, along with handrails to prevent falls

 

Everywhere else:

  • Check for a clear pathway for walking: No rugs, room dividers that can be tripping hazards, or slippery floors
  • Install nightlights in the bedroom, bathroom, and hallways for safety at night
  • Consider installing hand rails for assistance by the bed, or in well-trafficked areas
  • Check all smoke detectors regularly, to ensure they’re still working
  • Purchase fire extinguishers and keep them in strategic places around the home
  • Keep emergency contact numbers posted in an accessible location
  • Consider special equipment such as a hospital-style bed, a lift for the stairs, and ramps for wheelchairs

 

Consider communication. These days, we have access to technology that can assist us in caregiving duties. Your choices will of course be guided by the interest and abilities of your loved one, but some common options include:

  • A bell or some other device, so that he or she can summon you without having to yell across the house
  • Program a phone with speed dial, so that you or your loved one can access help quickly in an emergency
  • Select a phone with a large digital display, for easy reading
  • Consider a phone with voice enhancer if your loved one has hearing difficulties
  • A medical alert system can help your loved one get help with just a push of a button (this is essential if you ever leave him or her alone for short periods of time)
  • A baby monitor isn’t just for babies; it can help you keep an “ear” on your loved one while you cook, do yard work, take a shower, and so on

 

As a trusted member of our community, Hospice of the Valleys, a nonprofit 501(c)(3) has been providing hospice care to the Inland Valley and Fallbrook for over 34 years. Please call us for senior community resources, or for information about hospice care. We’re here to help. 951-200-7800.

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