The following "Frequently Asked Questions and Answers" are specifically for those in the United States: (For those living in other countries outside of the United States, please refer to your country’s specific guidelines. We apologize for any inconvenience. If you require any assistance finding information, write to us at "Contact Us" and we will reply as soon as possible. Thank you.)
What is Hospice Care?
Who Makes Up the Hospice Team?
Hospice care is a family-centered approach that includes a team of doctors, nurses, home health aides, social workers, chaplains, counselors, and trained volunteers. This team works together to care for the needs of the dying patient. This care focuses on the physical, emotional, social, and spiritual needs of the patient, as well as the emotional and spiritual needs of the family members. The goal of hospice care is to help keep the patient as pain-free as possible, with loved ones nearby until death. The hospice team develops an individualized care plan that meets each person’s specific needs for pain management and symptom control. Other members of the team may include speech therapists, physical therapists, and occupational therapists, when needed. Often, the patient’s personal physician may also be included. However, a patient can choose to have their personal doctor take charge of the medical care or he or she may choose to have the hospice medical director take charge of the medical care. Another option is to have both the physician and the hospice medical director work together to coordinate the person’s medical care, especially when symptoms are difficult to manage. Regardless of who the patient chooses, the hospice medical director is available to answer questions the patient or family may have regarding hospice care.
Who is the Primary Caregiver?
Often, family members, such as a spouse or adult child, take on the role as the patient’s primary care giver. It is simply not possible for one person to provide care 24/7. Therefore, if at all possible it is recommended that other family members or friends lend a hand and take regular shifts so that the primary caregiver can get the rest he or she will need. Hospice staff will lend support to the caregivers and will teach them what they need to know in order to care for their loved one. Sometimes a close friend becomes the primary caregiver for a patient when family members are unavailable or unable to perform this task.
What Can I Expect From the Hospice Team?
How is hospice different from other medical care?
Hospice recognizes that a serious illness affects the entire family as well as the person who is terminally ill. The family, not just the patient, is seen as one “unit of care” for hospice professionals. Therefore, the family is also cared for emotionally and spiritually by the hospice staff while they are also caring for the terminally ill patient.
What services does hospice provide?
When should patients and families consider hospice?
After a diagnosis of a life-limiting disease, patients and their families should consider their choices for care. A patient does not have to be bed-bound or critically ill to be admitted to hospice. A hospice nurse and/or a hospice physician is called in to speak with you and your loved ones about your options for care.
Who is eligible for hospice care?
Doesn’t accepting hospice care mean I am “throwing in the towel or simply “giving up”?
Hospice involves acknowledging that most diseases in their advanced form cannot be cured. It does not mean giving up hope. The focus of hope shifts towards helping the patient achieve as much physical comfort given his or her disease as well as a feeling of peace of mind.
What are the different levels of hospice care?
Levels of Hospice Care:
What if I choose hospice and then live more than six months?
Hospice care does not automatically end after six months. Medicare and most other insurance companies with a hospice benefit will continue to pay for hospice care as long as a physician certifies that the patient continues to have a limited life expectancy.
What if my condition improves?
Occasionally, the quality of care provided by hospice leads to improved health, and life expectancy exceeds six months. When this happens, the hospice staff will transfer care to a non-hospice care provider. Later, when patients become eligible for hospice services again, they can re-elect the hospice benefit.
How does hospice manage pain and other symptoms?
Hospice physicians and nurses are experts at pain and symptom management. They are continually developing new ways of keeping patients comfortable and as alert and independent as possible. They know which medications to use alone and in combination with other medicines in order to provide the best results for patients. The goal is to provide “quality of life for the hospice patient” in the limited amount of time he or she has left.
Will I feel “doped up” on pain medication?
When morphine and other pain medicines are administered properly for medical reasons, patients find much-needed relief without getting “high” or craving drugs. The result is that hospice patients remain more alert and active because they are not exhausted by uncontrolled symptoms. If a patient’s pain requires an opioid for pain relief, then within the first few days of first receiving this medication, especially when the patient has never taken these medicines previously, he or she may appear more drowsy and sleep more. In approximately a week, the patient will develop a tolerance to this common side effect and will soon become more alert, sleeping less hours during the day so he or she can spend more quality time with family and friends. The hospice nurse is expert at watching for side effects to medications and will know what to do if this and other side effects do not resolve quickly.
What kind of emotional and spiritual support does the hospice staff provide?
Hospice recognizes that people are more than a group of symptoms. People nearing the end of their lives often face emotional and spiritual distress. They may feel saddened as their physical abilities begin to decrease. They are afraid of being a burden to their families. They often are concerned about how their loved ones will manage after they are gone. Spiritual and emotional pain can appear in many forms. Often, they feel deep regret about things they have done or said – or they think of things that are left undone and unsaid. Hospice professionals and volunteers are trained to be good listeners and to help patients and families work through some of these concerns. In this way, one of the staff’s goals for the patient is to help him find peace and emotional comfort in his final days. The goal for the family and other loved ones is to help them reach sound conclusions and closure with their loved one who will soon pass on.
Below is a list of things to consider when thinking about contacting a local hospice:
Who Pays for Hospice Care?
What Is the Medicare Hospice Benefit?
Who is Eligible for Medicare Hospice Benefits?
In the U.S. a person is eligible for Medicare hospice benefits when he or she meets all of the following conditions:
What Does Medicare Cover?
The Medicare Hospice Benefit:
In the United States, if you have Medicare Part A (Hospital Insurance) and meet all of these conditions, you can get hospice care:
Your hospice doctor and your regular doctor (if you have one) certify that you’re terminally ill (with a life expectancy of 6 months or less).
You accept palliative care (for comfort) instead of care to cure your illness.
You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.
Your costs with Medicare
You pay nothing for hospice care.
You may need to pay a co-payment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it’s covered under Part D.
You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
Medicare doesn’t cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
Things to know
Only your hospice doctor and your regular doctor (if you have one) can certify that you’re terminally ill and have a life expectancy of 6 months or less. After 6 months, you can continue to get hospice care as long as the hospice medical director or hospice doctor re-certifies (at a face-to-face meeting) that you’re terminally ill. Hospice care is usually given in your home but may also be covered in a hospice inpatient facility. Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions, but this is unusual. When you choose hospice care, you decide you no longer want care to cure your terminal illness and/or your doctor determines that efforts to cure your illness aren’t working. Once you choose hospice care, your hospice benefit will usually cover everything you need.
Medicare won’t cover any of these once your hospice benefit starts:
Treatment intended to cure your terminal illness and/or related conditions. Talk with your doctor if you’re thinking about getting treatment to cure your illness. As a hospice patient, you always have the right to stop hospice care at any time.
Prescription drugs to cure your illness (rather than for symptom control or pain relief).
Care from any hospice provider that wasn’t set up by the hospice medical team. You must get hospice care from the hospice provider you chose. All care that you get for your terminal illness must be given by or arranged by the hospice team. You can’t get the same type of hospice care from a different hospice, unless you change your hospice provider. However, you can still see your regular doctor or nurse practitioner if you’ve chosen him or her to be the attending medical professional who helps supervise your hospice care.
Room and board. Medicare doesn’t cover room and board if you get hospice care in your home or if you live in a nursing home or a hospice inpatient facility. If the hospice team determines that you need short-term inpatient or respite care services that they arrange, Medicare will cover your stay in the facility. You may have to pay a small copayment for the respite stay.
Care you get as a hospital outpatient (like in an emergency room), care you get as a hospital inpatient, or ambulance transportation, unless it’s either arranged by your hospice team or is unrelated to your terminal illness and related conditions.
We hope this information has been helpful. For more information, we suggest you call your local hospice agency.
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