It's common to have a lot of questions when considering hospice care for you or a love one. We hope this page helps! If you do not see an answer to your questions, please call us directly to speak with our hospice team.
Hospice care is focused on ensuring patients and their caregivers achieve the highest quality of life possible while facing an advanced life-threatening illness.
Rather than treating the disease, hospice treats the patient and the symptoms of the disease. Hospice is appropriate when patients no longer wish not to pursue aggressive treatments to combat their disease (i.e., cease curative treatment). For example, a cancer patient may no longer want to undergo continued chemo or radiation therapy as the chances of success are low; instead, choosing to focus on their quality of life with the time they have remaining, at home, surrounded by friends and family.
Hospice care takes a collaborative approach in developing the plan of care for patients; typically, involving input from the patient, family, and the varied disciplines involved in the hospice care team.
If a patient is eligible for Medicare part A, they will pay nothing for their hospice care. The Medicare hospice benefit will cover the cost of all scheduled visits by the hospice interdisciplinary team, medication related to the patient's primary diagnosis, medical equipment in the home, supplemental supplies, and more. Medicare covers all of the services listed under the Our Services section of our website under the hospice benefit.
Typically, Medicaid will cover the cost of hospice care, including room and board at a qualifying long-term care facility. However, with Medicaid, there may be some implications on your estate you may want to consider through discussion with our hospice social worker and Medicaid to ensure you fully understand your benefit.
Commercial insurance covers hospice at varying levels depending on your plan. Please call us with your member ID card to help us verify your insurance coverage for the hospice benefit.
Palliative and hospice care occur at different stages of a patient's disease progression. While both services ensure the patient is comfortable, provide symptom management and psycho-social support, there are a few key differences outlined below:
1. Cost: Palliative care is typically paid for by insurance or by the patient directly, while hospice care is paid for by Medicare, Medicaid, insurance, or the patient.
2. Disease Progression: Palliative care is appropriate at any stage of a patient's disease, while hospice care is appropriate only when a patient has a 6 months or less life prognosis.
3. Curative Treatment: Palliative care can be provided simultaneously with curative treatment, while hospice care excludes curative treatment.
4. Location of care: Palliative care typically is provided in a hospital setting, while hospice care is provided in the patient's home.
Hospice is recommended when the disease gets to the point where it can be no longer cured or controlled, when a patient no longer wishes to pursue curative treatment, and when life expectancy is expected to be 6 months or less.
Studies and our own experience have shown that most patient's wait too long along the disease progression before considering or electing for hospice care. We encourage all patients and families to seek curative treatment and explore all options before selecting hospice care. However, we also encourage them to consider hospice care earlier rather than later so that our hospice team can have the time needed to ensure our patients and their family can utilize the full hospice care benefit.
The following are early indications that you may need to consider hospice care:
1. Significant weight loss
2. Loss of appetite with a significant decrease in food consumption
3. Increased hospitalization or emergency room visits
4. Uncontrolled pain
5. Shortness of breath
6. Increase in the amount of time spent sleeping (10-12+ hours a day)
7. Inability to perform daily tasks such as getting yourself out of bed, eating, washing, or getting dressed.
8. Frequent infections
9. A significant decline in overall health
10. Uncontrolled nausea or vomiting
Yes! You have the freedom to go into hospice care just like you have the freedom to leave hospice care, at any time, for any reason. Typically, we see patients leave hospice care as they wish to re-pursue curative treatment for their disease.
Yes! You have the freedom to choose which hospice agency participates in your care!
Unfortunately, we see far too many healthcare companies who also own hospice agencies mislead patients into believing they have to use their hospice agency in their community or healthcare network. This is a lie! Legally, every patient has the right to select their hospice agency to provide care in their place of residence, whether it is a skilled nursing facility, assisted living community, or private home.
At the same time, a patient has the right, at any time, to notify their existing hospice agency that they would like to transfer to another hospice if they are not satisfied with current services. A hospice agency has no right to deny a transfer.
Hospice care is considered supplemental care for the patient and their primary caregiver. While we offer 24/7 on-call nursing support, we are not the primary caregiver for the patient and do not provide around-the-clock care in the home.
When a patient elects to go into hospice care, they must designate a primary caregiver, usually a family member or close friend. Our hospice will work in conjunction with the patient and caregiver to ensure their needs are met at home.
The hospice interdisciplinary team (IDT) is a team of hospice professionals from various disciplines who manage our patients and their family's clinical and psycho-social needs. The IDT team is typically comprised of a:
1. Hospice Medical Director
2. Registered Nurse Case Manager
3. Licensed Master Social Worker
4. Chaplain
5. Certified Nurse Assistant
6. Volunteers, and more.
The IDT team will interact in various capacities with your family and come together every two weeks to discuss how our patients and families are doing from the perspective of their respective disciplines. This helps paint a picture on the overall well-being of our patients and their family and allows our IDT team to adjust care plans as necessary.
The hospice admission process begins with either a call to us from the patient or their family or a referral from the patient's doctor, social worker, or case manager. The phone call is the first step in connecting with our hospice nurse to ensure all of your family's questions are answered. During the first call, we advise that you have the following available to share with us (if available):
1. Health Insurance Card (i.e., insurance card, Medicaid card, Medicare Beneficiary Identifier (MBI) card).
2. Contact information or name of any primary care doctors, specialty doctors, home health agencies, previous hospice, or hospitals the patient has visited in the past year. Our hospice team will reach out to each doctor or healthcare organization to request medical records. Once medical records are received, our hospice team and medical director will review eligibility and help develop the patient's plan of care.
3. A doctor's order from the patients' primary care physician stating the patient has a terminal diagnosis with a life expectancy of 6 months or less and to evaluate and treat if appropriate for hospice care.
Additional information will be required, but the above are the primary items needed to begin the process and ensure no delays in the hospice admission process. Rest assured that our hospice team will take responsibility for obtaining the vast majority of the items required; we will need your family's guidance to contact the appropriate parties.
Once all information has been received and reviewed, we will send out hospice nurse to do an in-home evaluation and admit if appropriate into our hospice program once all appropriate admission paperwork is completed and reviewed by your family.
Admissions can be made in as little as a few hours to a few days depending on the patients' acuity, their need for immediate hospice care, and our hospice teams' ability to obtain medical records and orders from referring physicians.
Ultimately, you need to have a doctor certify that you have a life expectancy of 6 months or less in order to be eligible to receive hospice care. Each disease has a different progression and therefore has different criteria we look to determine if they meet Medicare/Medicaid eligibility criteria for hospice. Through a discussion with your family, review of medical records from previous healthcare providers and a nursing assessment in the home, we are generally able to paint the full picture of a patients disease and diagnosis to ensure eligibility for hospice care.
You can take our free hospice eligibility quiz and discuss your results with one of our hospice nurses by clicking here.