What is hospice?
Hospice is a compassionate form of care that is designed to provide treatment and comfort for those who are facing a life-limiting illness. It offers a support system of medical, social, psychological, and spiritual services that promotes dignity and affirms quality of life which allows the patient, family, and other loved ones to make choices about what is important to them.
How does it work?
In most cases, a family member serves as the primary caregiver and helps make decisions for a loved one. The caregiver, along with other members of the hospice care team, develop a plan to provide treatment, support, personal care, and a number of specialized services for both the patient and family. Hospice staff is available 24 hours a day, 7 days a week to provide assistance in managing your individual needs.
The hospice care team includes:
- The Patient and Family
- Attending Physician
- Hospice Physician
- Nurses
- Home Health Aides
- Social Workers
- Physical, Speech, and Occupational Therapists
- Volunteers
- Spiritual Counselors
- Bereavement Counselors
Who is eligible for hospice?
The hospice benefit is intended primarily for any individual with a terminal illness whose life expectancy is six months or less should the illness run its usual course. However, the Medicare program recognizes that not all terminal illnesses have a predictable course; therefore, the benefit is available for extended periods of time beyond six months.
What services does your hospice agency provide?
All services are available 24 hours a day, 365 days a year at no cost to the patient or family members when the hospice benefit is chosen.
- All medicines, medical equipment, and supplies related to the hospice diagnosis
- Medication management to control pain and symptoms
- Physician services to manage medications
- Nursing and home health aide visits to provide direct care
- Social work, counseling, and chaplain services to provide support
- Volunteer services to provide companionship
- Bereavement services for a minimum of 13 months following a loss
How can I arrange for these services?
Anyone can make a referral for hospice. You should feel free to speak with your doctor, your minister, or a trusted friend when making this decision. You may also choose to contact us to learn more about our services and arrange a meeting in your home to discuss the program. We are also available to meet with you and provide care in local hospitals or extended stay facilities such as nursing homes.
When should a decision about choosing hospice be made, and who should make it?
It is appropriate to discuss someone's health care options, including hospice, at any time. The best time to discuss hospice care is before an illness strikes. By law, the decision to elect hospice belongs to the patient and/or his or her legal guardian. If you are not comfortable in discussing this decision with a loved one, contact your physician or one of our representatives who are always available to assist you.
What if my physician doesn't know about hospice?
Most physicians know about hospice. However, if your physician does not, or would like to receive more information about the program, it is available from our hospice agency, the National Hospice Palliative Care Association (800-658-8898), the Centers for Medicare and Medicaid Services Hospice Center (www.cms.hhs.gov/center/hospice.asp) and many other health related organizations.
Can I keep my personal physician if I choose hospice?
Yes. You may keep your personal physician while under the care of hospice. Hospice reinforces the primary physician/patient relationship and considers this bond to be a high priority.
What does the hospice admission process involve?
Once you have made a decision to select hospice, a representative will contact you to discuss the program and help determine your eligibility. Your physician will then be contacted to discuss your decision and receive authorization to begin providing the services that you have chosen. Finally, you will be asked to sign certain forms that are similar to the ones that you would sign before receiving any other special medical treatments or services.
Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Yes. If a patient's condition improves and the disease goes into remission, the patient can be discharged from hospice and returned to regular medical treatment. Likewise, should the patient ever need to return to hospice in the future, these services could be resumed at the patient's request.
Is there any special equipment or changes I have to make in my home before hospice care begins?
No. Your hospice provider will help you determine what you need and then assist you in obtaining any special equipment or making any changes in your home.
How many family members or friends does it take to care for a patient at home?
There's no set number. One of the first things hospice will do is to prepare a plan that will help you determine the amount of care that is needed. In addition, hospice staff will make regular visits to your home and are always available to answer questions, provide support, and teach caregivers.
Must someone be with the patient "at all times?"
No. It is usually not necessary for someone to be with the patient all the time. However, hospice does recommend that someone be with the patient at all times in the later stages of care.
How difficult is caring for a dying loved one at home?
It is never easy and can sometimes be quite hard. Nights can be especially difficult and sometimes seem very long. However, hospice staff is available 24 hours a day to speak or visit with you if necessary.
What do hospice volunteers do?
Hospice volunteers are a special group of people that give of their time and talents to assist patients and their families. They are available to visit with you and help run errands. They can also assist with daily activities and may perhaps read, sing, write letters, or just reminisce with you and your loved ones about life's many experiences. Their support both enhances the quality of life for patients and helps relieve some of the demands that are often placed on caregivers.
Can I be cared for by hospice if I reside in a nursing home or other type of long-term care facility?
Yes. All hospice services can be provided in a nursing home if the facility has a written agreement to provide these services to their residents. In addition to the standard services provided by the nursing home or alternate care facility, residents will receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers.
How does hospice "manage pain?"
Hospice believes that emotional and spiritual pain are just as real as physical pain. Hospice nurses and doctors use the latest and most effective medications and devices to treat all forms of pain and relieve symptoms. In addition, they are often joined by specialists who are trained in physical therapy, music therapy, art therapy, massage therapy, and nutritional counseling to help maintain comfort. Finally, various counselors, including clergy, are available to assist family members and patients in dealing with their illness.
What is hospice's success rate in battling pain?
Very high. Using a combination of medications, counseling, and therapies, most people can attain a level of comfort that is acceptable to them.
Will medications prevent me or my loved one from being able to talk or know what's happening?
Usually not. It is the goal of hospice to help individuals live as actively as possible, free of pain or discomfort.
Is hospice care covered by Medicare and insurance?
Hospice services are widely available and covered by Medicare Part A. They are also covered by Medicaid in most states, as well as many other private or managed care insurances.
Services covered by Medicare include:
- Medications for symptom management and pain relief
- Medical equipment and supplies
- Physician services
- Nursing care
- Home health aide and homemaker services
- Social worker services
- Physical, occupational, and speech therapy
- Nutritional, spiritual, and grief counseling
- Short-term general inpatient care and respite care
If a patient is not covered by Medicare or any other health insurance, will hospice still provide care?
Yes. The first thing hospice will do is assist you in finding out whether you are eligible for any coverage. If not, most hospices will provide care for anyone who cannot pay by using money raised from the community or from memorial funds.
Does hospice provide any help to the family after a patient dies?
Yes. Hospice provides continuing contact and support for caregivers and families for up to 13 months following the death of a loved one. We also sponsor bereavement groups, conduct memorial services, and provide support for anyone in the community who has experienced the death of a family member, friend, or loved one.
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