Hospice is individualized end-of-life care to enhance quality of life for people who are coping with any life limiting illness. With hospice, a team of specialized health professionals, skilled in pain and symptom management, provide comfort and care to patients, their families and caregivers.
What is hospice care?
Hospice focuses on caring, not curing and in most cases care is provided in the patient's home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.
- Hospice care honors the whole person so that emotional, social, and spiritual needs addressed along with the physical.
- Hospice care is skilled and compassionate with the goals of comfort, freedom from pain and other distressing symptoms, while fostering personal independence for as long as possible.
- Hospice care is provided by a team of healthcare professionals, each addressing the different needs of the person and the family. Specially trained volunteers are also available for extra help and to give family members a break.
- Whenever possible people who choose hospice care continue to live in the comfort of their own homes in the care of those who know and love them best. However for those whose needs cannot be met at home, hospice care is provided in assisted living, nursing, hospital, and hospice facilities.
- Hospice services are fully covered under Medicare Part A; Medicaid and many private insurance plans offer a hospice benefit.
- Hospice care encourages the use of regular maintenance medications or medications that improve comfort and quality of life.
- The decision to enroll in hospice can be changed at anytime if the person’s illness improves or if the person chooses to resume curative treatment.
When is the right time to ask about hospice?
Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members 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 meets each patient's individual needs for pain management and symptom control. The team usually consists of:
- The patient' s personal physician;
- Hospice physician (or medical director);
- Home health aides;
- Social workers;
- Clergy or other counselors
- Trained volunteers; and
- Speech, physical, and occupational therapists, if needed.
What services are provided?
Among its major responsibilities, the interdisciplinary hospice team:
- Manages the patient’s pain and symptoms;
- Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
- Provides needed drugs, medical supplies, and equipment;
- Coaches the family on how to care for the patient;
- Delivers special services like speech and physical therapy when needed;
- Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
- Provides bereavement care and counseling to surviving family and friends.
Where is hospice care provided?
Most hospice care is provided at home — with a family member typically serving as the primary caregiver. However, hospice care is also available at hospitals, nursing homes, assisted living facilities and dedicated hospice facilities. Keep in mind that no matter where hospice care is provided, sometimes it's necessary to be admitted to a hospice inpatient unit or hospital. For instance, if a symptom can't be adequately managed by the hospice care team in a home setting, a hospice inpatient unit or hospital stay might be needed.
How does hospice care begin?
Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.
How to pay for hospice care?
Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers.