20 Frequently Asked Questions
Here are some of the questions most often asked about hospice. We hope they will help you better understand the hospice concept. Because individual hospices can differ, we urge you to contact Community Hospice of Baldwin County to find out what we can offer to you.
1) When should a decision about entering a hospice program be made—and who should make it?
At any time during a life-limiting illness, it’s appropriate to discuss all of the patient’s care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of “giving up” or stopping aggressive treatment for their disease. Hospice staff members are sensitive to these concerns and are always available to discuss them with the patient, family and physician.
2) Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.
3) What if our physician doesn’t know about hospice?
Most physicians are aware of hospice. If your physician wants more information, it is available from the American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local hospices, or the National Hospice and Palliative Care Organization Helpline, 1-800-658-8898. In addition, physicians and all others can also obtain information on hospice from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration.
4) Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Yes. If improvement in the condition occurs and the patient no longer meets the hospice criteria, the patient can be discharged from hospice and return to aggressive therapy or go on about his or her daily life.
If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
5) What does the hospice admission process involve?
One of the first things hospice will do is talk with the patient and family about the hospice benefit, to be sure they understand hospice. Then the hospice will contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Hospices may have medical staff available to help patients who have no physician.) The patient will also be asked to sign consent and insurance forms.
The so-called “hospice election form” says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.
6) Are there any special equipment changes I have to make in my home before hospice care begins?
Your hospice provider will assess your needs, recommend any necessary equipment, and help make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the disease progresses.
7) How many family members or friends does it take to care for a patient at home?
There’s no set number, but a patient must have a competent caregiver, if the patient is unable to care for him/herself. One of the first things a hospice team will do is prepare an individualized care plan that will, among other things, address the amount of care-giving a patient needs. Hospice staff visit regularly and are always accessible to answer questions and provide support.
8) Must someone be with the patient at all times?
This will be individualized, according to the patient needs and wishes.
While family and friends must be relied on to give most of the care, hospices do provide volunteers to assist with errands and to provide a break and time away for major caregivers.
9) How difficult is caring for a dying loved one at home?
It’s never easy and sometimes can be quite hard. Hospices have staff available around the clock to consult with the family and to make visits as appropriate.
10) What specific assistance does hospice provide home-based patients?
Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, hospice aides, clergy, therapists, and volunteers—and each provides assistance based on his or her area of expertise. In addition, hospices help provide medications, supplies, equipment, inpatient services, and additional helpers in the home, as appropriate.
11) Does hospice do anything to make death come sooner?
Hospices do nothing either to speed up or to slow down the dying process. Hospice provides its presence and specialized knowledge during the dying process.
12) Is the home the only place hospice care can be delivered?
No. Although most hospice services are delivered in a personal residence, some patients live in nursing homes or hospice centers.
13) How does hospice “manage pain”?
Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialist schooled in music therapy, art therapy & diet counseling. Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these, as well. Counselors, including clergy, are available to assist family members as well as patients.
14) What is hospice’s success rate in battling pain?
Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
15) Will medications prevent the patient from being able to talk or know what’s happening?
Usually not. It is the goal of hospice to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
16) Is hospice affiliated with any religious organization?
Hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
17) Is hospice care covered by insurance?
Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in some states, and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
18) If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?
The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, most hospices will provide care for those who cannot pay, using money raised from the community or from memorial or foundation gifts.
19) Does hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. Most hospices also sponsor bereavement and support groups for anyone in the community who has experienced the death of a family member, a friend, or a loved one.
20) If the patient is eligible for Medicare, will there be any additional expense to be paid?
Medicare covers all services and supplies related to the terminal illness for the hospice patient. In some hospices, the patient may be required to pay a 5% or $5 “co-payment” on medication and 5% co-payment for respite care. You should find out about any co-payment when choosing a hospice.