Deciding whether or not it's time to initiate hospice can be difficult. To help inform you before making that decision, we have compiled a list of frequently asked questions. If you don't see the answer to your question below, please contact us.
Jean Chubb, RN, MSN
Director of Home Health and Hospice
Can a Hospice patient who shows signs of recovery be returned to medical treatment?
Certainly. If improvement in the condition occurs and the disease seems to be in remission, 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.
What does the Hospice admission process involve?
One of the first things Hospice will do is contact the patient's primary physician to make sure he or she agrees that Hospice care is appropriate for the patient at this time. The patient will also be asked to sign consent and insurance forms. The "Hospice election form" says the patient understands that the care is palliative (that is, aimed at pain relief and symptom management) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing Medicare Hospice benefit affects other Medicare coverage for a terminal illness.
Is there any special equipment or are there changes I have to make in my home before Hospice begins?
Hospice will assess your needs, recommend any necessary equipment, and make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the disease progresses.
How many family members or friends does it take to care for a patient at home?
There is no set number. One of the first things the Hospice team will do is prepare an individualized care plan that will, among other things, address the amount of caregiving a patient needs. Hospice staff visit regularly and are always accessible to answer questions and provide support and education to the caregivers. Care is kept as simple as possible.
Must someone be with the patient at all times?
In the early weeks of care, it is usually not necessary for someone to be with the patient at all times. Later, however, since one of the most common fears of the patient is the fear of dying alone and falls risk increases, hospice generally recommends someone be there continuously. Hospice is available around the clock to consult with the family and to make night visits when appropriate. Care is kept as simple as possible.
Does Hospice do anything to make death come sooner?
No. Hospice does nothing to speed up or slow down the dying process. Just as physicians and midwives lend support and expertise during the time of birth, Hospice provides its presence and specialized knowledge during the dying process.
Is the home the only place that Hospice can be delivered?
No. Although most Hospice services are delivered in a personal residence, some patients live in nursing homes or in Hospice centers.
How does Hospice manage pain?
Hospice nurses and physicians are highly skilled in pain and symptom management. They are up-to-date on the latest medications and devices to provide pain relief. 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.
What is Hospice's success rate in battling pain?
Very high. Using some combination of medication, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
Will medications prevent the patient from being able to talk or know what is 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, hospice has been very successful in reaching this goal.
Is Hospice care covered by insurance?
Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid, and by most private health insurance policies. To verify coverage, Hospice may assist you in contacting your insurance provider.
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. Hospice is able to provide care to those who do not have the ability to pay due to the generous donations from individuals, organizations, corporations, foundations and businesses. Each contribution is deeply appreciated.
Does Hospice provide any help to the family after the patient has died?
Hospice provides continuing contact and support for family and friends for one year following the death of a loved one. The Hospice program also offers bereavement support groups at the hospital.