Hospice

What is hospice?

Hospice care focuses on improving the quality of life for persons and loved ones faced with a life-limiting illness.  People become hospice-eligible when it is expected they will die from their condition within 6 months, although many patients live longer than this and can remain in hospice.  The primary goals of hospice care are to provide comfort, relieve physical, emotional and spiritual suffering, and promote the dignity of terminally ill persons.  Hospice care neither prolongs nor hastens the dying process but assures comfort.

Is hospice a place?

Hospice care is a philosophy or approach to care rather than a place.  Care may be provided in a person’s home, nursing home, assisted living, hospital, or independent facility devoted to end of life care.

Who pays for hospice?

Medicare, Medicaid and private insurance generally cover hospice.  There are companies/policies that require a co-pay, but this is not the norm.  Hospices are paid a daily amount by the insurance provider to take care of the person, and out of this payment, hospice provides all services, including medicine, medical equipment, wound care supplies, professional visits and bereavement support. 

Does a referral to hospice mean the person’s doctor has given up on him/her?

On the contrary, a referral to hospice means that a doctor recognizes that the illness is advancing despite every effort to treat it, and the person needs specialized treatment to maximize their comfort and quality of life.  It is an important time for a thorough conversation between physicians, patients and their loved ones to understand where they are in the course of their illness, and what the recommended options are for them.  It is a time when the health care team may assess that the discomfort of aggressive treatments are no longer beneficial.   This often comes as a relief to people who are tired of being in the hospital, tired of going through painful treatments, and tired of the hassle of frequent doctor appointments that accompany these treatments.

What exactly does hospice do for people?

  • Hospice care is provided by a team of people, including a doctor, an RN, a nurse’s aid (CNA), a social worker, a chaplain, volunteers and occasionally a physical therapist.  You will be admitted (signed up) by a nurse, who will assess your need for medical equipment, review your medicines with you and the hospice doctor, and provide an appropriate medical regimen for your comfort.  Depending on what is needed at the time, this regimen will usually include your regular maintenance medicines such as blood pressure or diabetes medicines in addition to comfort medicines.
  • The nurse will make sure that caregivers feel comfortable with the medicine and care routine, and are always available for questions or other help.  The team is there to guide families through this unfamiliar territory.
  • Hospice will provide any medical equipment you need such as a hospital bed, wheelchair or oxygen. 
  • A CNA will provide help with bathing as needed, whether it’s daily or once a week.
  • A social worker will provide visits for emotional support for patients and families.
  • A chaplain will visit as desired by patients or family members for spiritual support.
  • Wound care supplies, adult diapers, disposable pads, barrier cream, urinals, gloves, wash basins, etc. are all provided by hospice.
  • Volunteers may provide companionship for a patient, sit with a patient while a caregiver is away for an afternoon, bring a therapy dog to visit, or other such support.
  • Hospice will manage medicines, making sure patients don’t run out.
  • Hospices provide a nurse on call 24 hours a day, every day.
  • Hospice care includes bereavement support to loved ones for 13 months after a patient has died.

What DOESN’T hospice do?

  • Hospice does not provide live-in or all-day care unless the patient’s needs dictate inpatient hospice facility care.
  • Hospice does not do routine diagnostic tests, such as X-rays or lab draws.
  • Hospice does not use IV medicines or fluids, except in rare cases when pain cannot be managed by any other route.
  • Hospice does not require you to go to doctor appointments.
  • Hospice does not stop your regular medicine unless you want to stop it.
  • Hospice does not pay for any aggressive treatments such as chemotherapy, radiation, hospitalization, or blood transfusions.
  • Hospice does not artificially prolong life, but improves quality of life.
  • Hospice does not artificially shorten life. It allows natural death, and keeps patients from suffering while at end of life.