Hospice - Matthew Personius, MD

Ask A Doctor - Union Democrat
Matthew Personius, MD
Hospice

Q: What is hospice?
A: Hospice is an organization whose primary purpose is to assist patients and families through the end of life process. This entails a comprehensive, team approach to medical care with a focus on symptom management, education and empowerment of patients and family members, and the maintenance of dignity during the final months, weeks, and days of a Hospice patient's life.

Q: When is a patient referred for hospice care?
A: Potential Hospice patients are those who, with reasonable certainty, have a terminal condition with a prognosis of six months or less. There is no restriction on the type of condition as long as it satisfies the aforementioned criteria. Thus, it may be anything from a malignancy to end stage dementia to plain old age. The earlier a patient is referred to Hospice, the more they are able to benefit from the support and care the Hospice teams provide. There is a misconception that Hospice should be reserved for those who are at the extreme end of life, and while we are able to be of great service to those in this situation, there are distinct advantages to early referral including a broader array of services provided, providing necessary medications through the Hospice pharmacy benefit, family support, and long term relationships with care providers.

Q: Are there any specific requirements that patients must meet to receive hospice services?
A: Anybody who has a condition satisfying the above requirements, and who has or will have a full time caregiver available to them may receive Hospice benefits. There are no restrictions per se as to physical or cognitive ability as long as a person meets the prognostic criteria.

Q: Who provides hospice care?
A: Hospice care is a comprehensive service which includes nursing care, home health aides, medical social workers, chaplains, volunteers, and of course physician treatment and review. Most Hospice patients retain their personal primary care physician throughout their time on Hospice which is ideal from the standpoint of continuity of care.

Q: Where do patients receive hospice care?
A: In the majority of cases, Hospice care is provided in the comfort of your own home. We make every effort to ensure that all necessary equipment is in place in a timely fashion in order to ensure comfort and prevent complications. Medical equipment is generally available through local medical suppliers and can be delivered at no expense to the patient in most cases. In some cases, Hospice patients live in the home of a family member, at an assisted living facility, or even in a skilled nursing facility or hospital.

Q: How are friends and family typically involved with the care of a hospice patient?
A: Family members are the most common caregivers we encounter in Hospice, often a spouse or child or even a parent in some cases. Other full time caregivers may be friends or paid caregivers. Nevertheless, it is unusual to have a Hospice patient who does not have family and friends intimately involved in care and support on a daily basis.

Q: Who pays for hospice services?
A: For those already on Medicare, the Hospice benefit is covered and all costs directly attributable to Hospice care are covered as well, including all medications and supplies required to manage the underlying condition. Those with private insurance or no insurance may face variable out of pocket costs depending on their situation.

Bio:
Matthew Personius M.D. is currently in a private house call practice in Sonora where he takes care of elderly and homebound individuals, as well as nursing home residents. He graduated from Berkeley with a degree in economics, and attended the University of Iowa College of Medicine in Iowa City. He went on to complete a residency in Family Practice from the University of Utah prior to moving to Sonora in 1997 where he took a job working for the county as a family practitioner. He and his wife have five children, and are very involved in coaching the local high school and club water polo teams.