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 your local hospice provider to find out about
the program in
your area.
At any
time during a life-limiting illness, it's appropriate to discuss
all of a patient's care options, including hospice. By law the
decision belongs to the patient. Understandably, most people
are uncomfortable with the idea of stopping an all-out effort
to "beat" their disease. Hospice staff members are
highly sensitive to these concerns and are always available to
discuss them with the patient, family and physician.
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The patient and
family should feel free to discuss hospice care at any time
with their physician, other healthcare professional, clergy or
friends.
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Most physicians know about 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
Helpline at 1-800-658-8898.
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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.
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One
of the first things hospice will do is 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. These are similar when they enter a hospital.
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.
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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.
In general, hospice will assist in any way it can to make home
care as convenient, clean, and safe as possible.
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There is
no set number. 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 visits regularly and are
always accessible to answer questions and provide support.
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In
the early weeks of care, it’s usually not necessary for
someone to be with the patient all the time. Later, however,
since one of the most common fears of patients is the fear of
dying alone, hospice generally recommends someone be there continuously.
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It’s
never easy and sometimes can be quite hard. At the end of a long,
progressive illness, nights especially can be very long, lonely
and scary. So, hospices have staff available around the clock
to consult with the family and
to make night visits as appropriate.
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Hospice patients are cared for by a team of doctors,
nurses, social workers, counselors, home health aides, clergy,
therapists, and volunteers. Each provides assistance based on
his or her area of expertise. In addition, hospices help provide
medications, supplies, equipment, hospital services,
and additional helpers in the home as appropriate.
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Hospice
does nothing to either speed up or slow down the dying process.
Just as doctors and midwives lend support and expertise during
the time of childbirth, so hospice provides its presence and
specialized knowledge
during the dying process.
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No. Most
hospice services are delivered in a personal residence; however,
care is also provided to patients who live in nursing homes,
assisted living centers, boarding homes, or adult family
homes.
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Hospice nurses and doctors are up-to-date
on the latest medications and devices
for pain and symptom relief. In addition, physical and occupational
therapies assist patients to be as mobile and self sufficient
as possible. They are often joined by specialists schooled in
music therapy, art therapy,
diet counseling, and other therapies.
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.
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Very
high. Using a combination of medications, counseling and therapies,
most patients can attain a level of comfort that is acceptable
to them.
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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.
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Hospice
care is not an off-shoot of any religion. Nor is it a requirement
that patients adhere to any particular set of beliefs.
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Hospice
coverage is widely available. It is provided by Medicare nationwide,
by Medicaid in some 42 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.
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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.
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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 death
of a family member, a friend, or a loved one.
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Medications and equipment
not related to the terminal illness are the responsibility of
the patient.
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