What is hospice care?
Hospice care focuses on helping people with terminal illnesses live as well as they can for as long as possible and rather than treating their disease. The hospice care team consists of healthcare professionals who address the physical, emotional, and spiritual issues the patients and their families are going through.
Who qualifies for hospice care?
Anyone with a life-threatening illness and a life expectancy of six (6) months or less, following the normal cause of the disease. A patient may opt for comfort care or hospice nursing instead of a curative or aggressive treatment.
Hospice Eligibility Requirements:
A patient diagnosed with a life-limiting condition, with a life expectancy of six months or less if their disease runs its normal course.
A patient with a declining functional status as determined by either:
- Palliative Performance Scale (PPS) rating of 50%-60% Dependent in at least 3 of 6 Activities of Daily Living (ADLs)
- Alteration in nutritional status (e.g. 10% loss of body weight over last 4-6 months)
- Observable and documented decline in the clinical condition in the last 4-6 months as manifested by at least one of the following:
- ≥ 3 hospitalizations or emergency department visits
- Decrease in tolerance to physical activity
- Decrease in cognitive ability
- Other comorbid conditions
Is hospice only for people who are dying?
Hospice care is for those who have been diagnosed with a life expectancy of 6 months or less if their disease runs its normal course. There are other indicators for hospice care for those terminally ill which includes more than 3 hospitalizations in the last 4-6 months, over 10% weight loss in the last 4-6 months, cognitive decline, or increase in dependence of 3 or more activities of daily living.
Does using hospice mean I’ve given up?
No. Although a patient may have reached a point where their condition cannot be cured, this does not mean there is nothing left to do. Hospice care focuses on the quality of life left. It eases pain and distress and allows patients to spend their time focusing on meaningful and important things. It is far from giving up. It helps loved ones support each other during stressful yet natural life passage.
Who pays for hospice care?
Patients have several payment options when it comes to routine care. If they have Medicare Part A and meets hospice eligibility requirements, then the government will pay as much as 100% of the cost. In such a case, there is no deductible and no copayment. Prescriptions and medical supplies related to the terminal illness diagnosis are also covered in the Medicare hospice benefit. Patients who do not have Medicare but have coverage from private insurance should ask their insurance company about the eligibility, deductibles, and copayments that may apply. Medi-cal or Medicaid provides coverage, however, it varies by state.
Once you begin care, can you cancel anytime?
Yes, An individual may elect to cancel hospice care for various reasons, such as resuming curative treatment. A patient may also improve in health and no longer meet the terminal illness eligibility nor the life expectancy of the 6-month guideline.
Can my loved one remain home for hospice care?
Yes. Hospice care is a service. Therefore, it is available wherever the patient resides.
Why would I want my loved one on hospice care?
Acceptance of end of life is not easy for any family member but acceptance of the fact that your loved one should have the highest level of comfort and dignity in their most difficult time of need is straightforward. Hospice is a benefit that your eligible loved one can qualify for to help them remain at home to receive concierge medical and personal care services, receive medical care from an interdisciplinary team including a Hospice Physician, nursing team, spiritual specialists, social workers, and more. Both the patient and the family member will have access to medical support 24/7 in the comfort of their home as needed. Hospice also provides bereavement services for up to 12 months for family members if they wish to participate. This is at no cost to the family and has proven to be a very valuable support service.
What are the rights hospice patients have?
Hospice care patients have the right to:
- Have a role in planning care
- Receive services ordered by the doctor
- Choose any Medicare-certified agency
How does hospice care work?
When the patient is determined eligible for hospice care, a team will meet with the patient and family to perform a full assessment to develop a custom nursing plan of care, a psychosocial evaluation, and a spiritual assessment. Regularly, weekly to biweekly visits will be made by a skilled nursing team and hospice aids as determined by the patient’s condition and needs in coordination with the hospice physician. They are also responsible for developing care plans that address the patient’s needs for symptom control or pain management to keep the patients comfortable in their homes. In addition, a support team consisting of the social worker and chaplain or life journey specialist will offer psychosocial and spiritual services as needed. Many times it’s not just the patient who needs assistance, but also the family and caregivers. Our nursing team also assists by providing proper education to families and caregivers to ensure the quality of care to the patients.
What do volunteers do for hospice patients?
Volunteers are there to aid patients and relieve their families for a short time during the day. These volunteers are able to assist with light household tasks, companionship, shopping, and transportation if appropriate.
Do I need a doctor to recommend hospice?
Doctors can recommend hospice but oftentimes, doctors or families wait too long to bring it up. This is why some patients receive hospice care so late. If you think a loved one may benefit from the support of hospice staff (i.e. hospice nurse) who specialize in easing distress and managing pain, give us a call to discuss if hospice care might be something to consider sooner than later. Our clinical care team and hospice physician can help evaluate your eligibility.