What is hospice?

Hospice care is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient's pain and symptoms, and attending to their emotional and spiritual needs.

How to know when it is the right time to call hospice?

If you are asking yourself when to call hospice, there is a good chance your loved one may already be eligible to receive this added layer of uniquely specialized care and support. Even if your loved one is not currently eligible for hospice care, gathering information about when you should call hospice before a crisis hits will give you time to understand the different options available and determine the best fit for your family.

What is the first step to getting started with hospice?

Once you have chosen a hospice, the first step is to call and set up an initial assessment of the patient’s needs. The call can be made by a family member, the patient, the doctor, or someone at the hospital.

Who is everybody that works on a hospice team?

The team usually consists of:

• Clergy or other counselors;

• Home health aides;

• Hospice physician (or medical director);

• Nurses;

• Social workers;

• Trained volunteers;

• Speech, physical, and occupational therapists, if needed;

• The person’s personal physician may also be included.

Where is hospice care given to patients at?

Hospice agencies most often provide services in the patient's home. Hospice care can also be provided by free-standing or independent facilities specially designed to provide hospice care, or through programs based in hospitals, nursing homes, assisted living centers, or other health care systems. Some hospice agencies offer both care in the home and care in an inpatient facility. In any setting, hospice care is designed to be available 24 hours a day, 7 days a week. Your doctor, hospital social worker, case manager, or discharge planner can be helpful in deciding which type of hospice program is best for you and your family.

What are the levels of care associated with hospice?

• Level 1: Routine Home Care.

• Level 2: Continuous Home Care.

• Level 3: General Inpatient Care.

• Level 4: Respite Care.

What are the differences between diagnosis and prognosis?

The words diagnosis and prognosis are commonly (though not exclusively) used in the medical field. Both terms contain the root word gnosis, which means "knowledge." But diagnosis and prognosis refer to different kinds of knowledge or information.

What qualifies a person for hospice?

Patients must meet two qualifications for Hospice:

1. Two physicians, the attending physician and the hospice medical director, must certify the patient is terminally ill, with a six-month or less life expectancy if the disease takes its normal course.
2. The patient and/or family must be aware of the prognosis and elect palliative or comfort care, rather than active curative measures.

How often do hospice doctors or nurses visit?

Visit lengths vary according to the patient and family needs. Most patients are initially seen by a nurse two to three times per week, but visits may become more or less frequent based on the needs of the patient and family. Visits are approximately 60 minutes long.

Can my PCP physician still be my doctor if on hospice services?

Yes. Hospice physicians and team members work with your doctor to ensure your clinical and emotional needs are being met and that your care is being carried out appropriately. Your doctor chooses his or her level of participation in your care.

How much say will a family have if their loved one is on hospice?

Yes. Family input is important and is the driving force behind developing the most effective plan of care for your mother.

What happens if a hospice patient has special needs?

The hospice plan of care is individualized to meet each patient’s needs. If special equipment (e.g., wheelchair, lift, trapeze bar, etc.) or therapies (e.g., respiratory therapy, physical therapy, etc.) are needed, the hospice provider offers these as part of its services. Perhaps the need is for a certain religious practice or person, a family or cultural tradition, a language other than English or another unique circumstance. Hospice providers address each patient’s needs.

What happens if a hospice patient needs special equipment

Your Hospice provider can provide the necessary equipment to help accommodate the patients needs.

What forms of communication is available to families of hospice patients?

You will always be notified of any change of condition that your hospice provider notices. The primary nurse may also be notified if any specific questions come up.

Why do i need hospice care if I have home health?

The Difference: Hospice Hospice care is comfort care for patients with a prognosis of six months or less if their disease runs its natural course, as certified by a physician. Home Health Home health services are brought to patients who require intermittent skilled nursing care, physical therapy, speech-language pathology services or continued occupational services, as prescribed by their doctor. The patient's progress must be documented. If the patient is eligible to receive Medicare benefits and you're unsure about the kind of care they need, learn more about the differences between hospice services and home healthcare below.

Will hospice provide 24/7 care for your loved one?

Hospice care covered by Medicare and most insurance companies does not cover 24-hour care giving. Since 1983, this Medicare benefit covers team services provided on an intermittent basis. Care giving is provided by family, friends, privately paid caregivers, and staff at the nursing facility.

What is end of life care?

Care near the end of life focuses on comfort rather than cure. It is care that accepts that the patient is declining and that attempts to reverse the course of their terminal illness would be futile or that side effects would outweigh any benefit. The patient is terminally ill and chooses comfort care, which is also known as palliative care.

What is comfort care?

Comfort care is an essential part of medical care at the end of life. It is care that helps or soothes a person who is dying. The goals are to prevent or relieve suffering as much as possible and to improve quality of life while respecting the dying person's wishes.

What is palliative care?

Palliative care is an interdisciplinary approach to specialized medical and nursing care for people with chronic conditions. It focuses on providing relief from the symptoms, pain, physical stress, and mental stress at any stage of illness. The goal is to improve quality of life for both the person and their family.

What happens after the death of my loved one?

Your hospice nurse, no matter when will come in and help pronounce the death. Following, your family will be assisted with the next steps for planning, and grief counsel if needed.

Does hospice help with any grief and other emotions?

Bereavement support is an essential component of Homestead Hospice that includes anticipating grief reactions and providing ongoing assistance for the bereaved over a period of 13 months. The death of someone you love can be one of the greatest sorrows that will occur in your lifetime. Bereavement is the period of grief and mourning after a death. Each person takes their own grief and healing journey, sharing memories, emotions and strategies for coping. Everyone feels grief in his or her own way and there are stages to the process of mourning and healing after the loss of a loved one. It starts with recognizing the loss and continues until that loss is eventually accepted.

Who pays for hospice?

There are many forms of hospice care payors, these are the most common of them:

• Medicare

• Medicaid

• Veteran’s Benefits

• Health Insurance

Will Medicare cover hospice care?

Yes.

• You pay nothing for hospice care.

• You may need to pay a copayment 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).

Will Medicaid cover hospice care?

Yes,

Medicaid will cover the costs of your loved one's room and board if your loved one is a resident of a long-term care facility or other qualifying assisted living facility. This coverage is unique to Medicaid and is not offered within the Medicare hospice benefit program.

Will VA Benefits cover hospice care?

Yes,

Since Hospice Care is part of the VHA Standard Medical Benefits Package, all enrolled Veterans are eligible IF they meet the clinical need for the service. There are NO COPAYS for Hospice Care, whether it is provided by the VA or an organization with a VA contract.

Will Insurance cover hospice care?

Depending on your insurance plan, it could cover Hospice Care. Check with your insurance company to see if your plan will cover hospice care, and which companies in your local area are in network with your insurance plan.

If a patient doesn't have insurance, can they still receive hospice care?

Yes, in some situations you can still receive hospice care if you have medicare, Medicaid, or VA benefits. If you do not have any of these, there are also local grants that can assist with payment.

Who pays for hospice room + board?

If your loved one is living in a long term care facility, and they have LTC Medicaid coverage – Medicaid will pay for Hospice Care and room + board.

How much is a hospice consultation?

A hospice consultation is always free with Divinity Hospice.

What are signs that could show hospice is right for a heart disease patient?

• Having a life-limiting illness.

• Progressive decline in status.

• Continued weight loss.

• Weakness and fatigue.

• Other uncontrolled symptoms.

What are the signs that hospice is right for Alzheimer + Dementia patients?

In order for a dementia patient to meet the hospice eligibility criteria, he or she must have a life expectancy of six months or less if the disease continues in its typical progression. For patients with dementia, it may be time to consider hospice when the patient’s physical condition begins to decline. Some key things to look for include: • a diagnosis of other conditions as COPD, CHF, cancer or congenital heart disease

• an increase in hospitalizations, frequent visits to the doctor and/or trips to the ER

• a diagnosis or pneumonia or sepsis

• weight loss or dehydration due to challenges in eating/drinking

• speech limited to six words or less per day

• difficult swallowing or choking on liquids or food

• urinary and fecal incontinence

• Unable to sit upright without arm rests on chairs or may slip out of chairs and require sitting in special chairs

• unable to walk without assistance such as a walker or now requiring a wheelchair

• unable to sit up without assistance (will slump over if not supported)

• no longer able to smile

What are the signs that hospice is right for an ALS patient?

These symptoms include difficulty with breathing, eating and drinking, swallowing and communication as well as pressure sores.

Will a patient receiving chemotherapy have to stop if they start hospice care?

Formal hospice care is only available to those who have stopped active cancer treatment that aims to cure. When medical professionals and patients agree that chemotherapy and other active treatments are not working and there is no prospect of remission, hospice care can take over.

What are the signs that hospice is right a Parkinson's disease patient?

Parkinson’s, while a chronic and progressive disease, has a course that can be uncertain with no clear indication of the end of life. Yet, those with PD often have additional significant medical problems such as advanced dementia, recurrent pneumonia, weight loss, urinary incontinence, infections and pain – that could be better managed through hospice.