What are some questions I should ask when looking for a hospice program?

Hospice care is a philosophy of care that accepts dying as a natural part of life. When death is inevitable, hospice seeks to neither hasten nor postpone it. Below is a list of questions you should consider when looking for a hospice program. 

• Is the hospice licensed? Are they Joint Commission Certified?
• What types of services are provided?
• What kind of support is available to the family/caregiver?
• What roles do the attending physician and hospice play?
• What does the hospice volunteer do?
• How does hospice work to keep the patient comfortable?
• How are services provided after hours?
• How and where does hospice provide short-term impatient care?
• Can hospice be provided in a nursing home or long-term care facility?

Who qualifies for hospice care? 
Hospice care is for any person who has a life-threatening or terminal illness. Most reimbursement sources require a prognosis of six (6) months or less if the illness runs its normal course. Patients with both cancer and non-cancer illnesses are eligible to receive hospice care. All hospices consider the patient and family together as the unit of care. 

How do I pay for hospice? 
Hospice care is covered by Medicare, Medicaid, and most private insurance companies.  

How do I receive hospice care? 
All you have to do is call us and ask for care. We’ll plan a visit and help determine if your loved one can benefit from hospice care. If so, we’ll work with your loved one’s physician to obtain an order for care. If not, we are happy to help you find other resources to help until it’s time for hospice care. 

How does hospice serve patients and families? 
Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, home health aides, social workers, chaplains, and trained volunteers. The team works closely together, focusing on the dying patient's needs, whether physical, psychological, or spiritual. The goal is to help keep the patient as pain-free and comfortable as possible, with loved ones nearby until death. 

• Physician for the medical direction of the patient's care.
• Regular home visits by registered nurses and licensed practical nurses.
• Home health aides and homemakers for services such as dressing and bathing.
• Social work and counseling.
• Medical equipment such as hospital beds.
• Medical supplies such as bandages and catheters.
• Drugs for symptom control and pain relief.
• Volunteer support to assist patients and loved ones. 

How does hospice care work?
Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week.

The hospice team develops a care plan that each patient's individual needs for pain management and symptom control. The team usually consists of the following individuals:

• The patient's personal physician
• Hospice physician (or medical director)
• Nurses
• Home health aides
• Social workers
• Clergy or other counselors
• Trained volunteers, and 
• Speech, physical, and occupational therapists (if needed).

Is there any special equipment or changes I have to make in my home before hospice care begins?
Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment.  Often the need for equipment is minimal at first and increases as the disease gets worse.  In general, hospice will assist in any way it can to make home care as convenient, clean, and safe as possible.

Must someone be with the patient at all time?
In the early weeks of care, its usually not necessary for someone to be with the patient all the time.  Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously.

What role do volunteers play in hospice care?
Because round-the-clock, hands-on care is central to the hospice experience, hospice provides trained volunteers to aid the family and patients.  Most hospice volunteers are trained to relieve the primary caregivers, do household chores. Perhaps their most important task is their ability to be "good listeners." 

Is care for the patient at home the only place care can be delivered?
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain.

Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief.  In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, massage, and diet counseling.

How does hospice manage pain?
While managed care organizations are not required to include hospice coverage, Medicare beneficiaries can use their Medicare hospice benefit anytime, anywhere they choose. They are not locked into the end-of-life services offered or not offered by the managed care organizations. On the other hand, those under 65 are confined to the managed care organizations services, but most provide at least some coverage for hospice.