The subject of hospice raises many questions, so having quick and clear answers can prevent added stress during a challenging time. On this page you will find answers to common questions regarding hospice care, medication, payment, coverage, insurance and more.
Hospice is funded by Medicare, Medicaid and also by most individual insurers. Hospice coverage is available to anyone that has a six-month or less terminal prognosis. The costs associated with most medications and therapies that relieve pain and provide comfort are covered as a part of hospice. Hospice services can actually remove some financial burden families or responsible parties, who may otherwise need to pay out-of-pocket for medications or equipment like beds or wheelchairs.
No. A patient who goes on hospice does not lose the ongoing care they are receiving for things like vision, dental, diabetes and more. A hospice representative should be able to help you understand more about how hospice care interacts with existing insurance and benefits.
The costs associated with most medications and therapies that relieve pain and provide comfort are covered as a part of hospice. Certain supplies and equipment, such as hospital beds, wheelchairs, oxygen equipment and others, are also provided under hospice coverage.
Medicare covers six months of hospice care initially, to match the six-month prognosis required for hospice to start. However, treatment can be renewed for as long as doctors believe that the patient has less than six months to live.
Drugs to reduce or eliminate pain can be prescribed by a hospice provider, which may include morphine. Existing medications are removed on a per-case basis, taking into account factors such as drug interactions, quality of life and the family’s wishes. American Care Hospice associates will make every effort to explain changes in medication to a patient’s loved ones.
Controlling pain is vitally important to allowing a patient to die with grace and dignity, and so is allowing the patient and their family a chance to share their remaining moments. Morphine is a proven medication that, in most cases, allows both to happen. Upon starting a drug like morphine a patient may experience some initial drowsiness, but after a few days the body builds up resistance to the sedating effects. Most patients whose pain is being successfully controlled by morphine do not have a problem with unusual sleepiness. However, there is a percent of patients whose alertness may decrease, leading them to choose an alternative method of pain control that may be less effective.
Hospice does not mean that you or your medical professionals are giving up. Hospice is a change of focus to a different set of goals – comfort and quality of life. Comfort care includes physical therapy, spiritual and emotional support, companionship and even the granting of life-long wishes. Hospice gives the patient and their family the opportunity to enjoy life and celebrate the bonds and memories they share.
In its simplest terms, hospice care is for patients who have been given a prognosis of death within six months while palliative care is for those with life-limiting or chronic conditions. The care philosophy of ensuring comfort is still at the core of both, but with palliative care it is delivered alongside curative treatments.
The goal of hospice is to provide comfort as the natural process of dying takes its course. In no way is there any effort or intention to hasten a patient’s death while on hospice, just to provide comfort while the patient’s journey comes to an end.
An evaluation for hospice can be requested at any time, then a terminal diagnosis will be required by a doctor for care to be approved. At this point a hospice provider can be contacted to start the hospice admission process (please note that “admission” refers to the start of service and does not necessarily reflect the patient being physically admitted to facility or new location).
If your loved one has a terminal condition and you think they may benefit from hospice care then we encourage you to speak to their physician about hospice. Some doctors are familiar with hospice and suggest is readily, but others may not be as familiar with its benefits and less likely to recommend it.
The option for hospice should be a serious consideration when a patient’s life expectancy is limited and they or their loved ones decide comfort and dignity are the ideal goals, though it is good to start the conversation before an illness reaches this stage. In terms of the patient’s wellbeing, Hospice is best considered when quality of life is lessened due to an ongoing state of care or treatment that is not projected to help the patient live any longer or more comfortably. The answer is different for each patient and their family, but in simplest terms, the option of hospice should be weighed when quality of life outweighs quantity of life.
The option of hospice is generally discussed among the patient (if possible), the primary care physician, the family and, when relevant, the patient’s care facility. In cases where the patient is unable to make the decision for themselves, an Advance Healthcare Directive can provide invaluable guidance. In cases where there has been no advanced planning the decision to start hospice is often left to the individual with Power of Attorney for the patient.
Except for exceptional circumstances involving 24 hour care for pain management or other acute conditions, most hospice cases involve periodic visits from doctors, nurses, volunteers and other team members. Care for the patient must still be provided predominantly by family, privately-paid in home caregivers or caregivers at the facility where they reside.
Visits from the hospice team can vary greatly depending on the patient’s conditions and needs, so it is not possible to give an accurate estimate. It is best to plan to address your needs and observations prior to the team member’s arrival to make the most of their visit.
Frequency of visits by team members depends upon the patient’s needs and condition, as well as the number of hospice programs the patient opts to receive or is eligible for. As a guideline it is best to assume that the nurse will visit twice weekly with periodic visits from other team members.
Hospice services can be provided at any number of locations, including most retirement and assisted living facilities. Because comfort and tranquility are the goals, great effort is taken to keep patients in place and prevent stresses involved with hospital readmissions or relocations to a dedicated hospice facility. American Care Hospice does not operate hospice facilities. Our hospice teams work on-site at patients’ residences, be they a private home, assisted living or other facility.
A patient or their family have the right to stop hospice at any time to resume curative care. Alternatively, some hospice patients can actually “graduate” off hospice if their life expectation goes beyond six months.
Occasionally a patient’s condition will show a marked improvement while they are on hospice. This can happen for any number of reasons, but if doctors believe the patient will live past six months then hospice care is stopped and the patient is said to have graduated.
A skilled hospice team is assembled to cover all aspects of end-of-life care. That said, a patient’s relationship with their doctor is a very important one and familiarity is vital and helpful. The American Care Hospice team is experienced in working with patients’ existing doctors to facilitate comfort for both patients and their families.
By definition, hospice is focused on care of a palliative nature. When starting hospice, curative treatments are stopped in favor of comfort measures.