Johnson County: End-of-Life Care Options

The Bird House is a community-based not for profit dedicated to providing compassionate, dignified end-of-life-care by focusing on the physical, spiritual and emotional needs of our guests and their loved ones in a peaceful, home-like environment.

There are sixteen Medicare certified hospice houses in the state of Iowa. None are in Johnson county. These facilities are operated by a single owner hospice agency often in conjunction with a hospital. Patient care here must be provided by registered nurses and caregivers and the houses must be approved by Medicare. The Standard Medicare hospice agency provides excellent, multiple levels of health care services for the dying based on clinical needs. The hospice agency interdisciplinary team is in charge of the care plan and determines the level of care for each patient. These levels of care include:
- Routine home care
- Medicare Acute Care
- Continuous care and
- Respite care (limited to five days)

Mercy Hospital, Iowa City, Iowa has a six bed acute hospice inpatient and respite care unit. (Respite care gives caregivers relief and must be approved by the hospice agency interdisciplinary team.) The maximum patient stay for respite care is five days per stay, however, and may be of limited restorative value to the caregiver.

Patients at end-of-life also have access to nursing home care as those rooms become available. Again, the hospice agency nursing care services are covered by Medicare but the room charge is not.

Home based end-of-life care is the most common chosen option. Current data indicates 87% of patients asked, indicated a preference to die in their own home. In 2013 only 66.6% of hospice patients died at home. The Bird House offers a holistic alternate homelike care setting that may help bridge the span-when the gap is caused by lack of adequate care giving.