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Hospice is a special type of care for those living with a terminal illness and a life expectancy of six months or less, should the disease run its natural course. It uses a team approach in which the care team focuses on the patient’s physical, emotional, and spiritual needs.
Although over 1 million patients and families experienced the value of hospice firsthand in 2018 alone*, there are still a lot of misconceptions about hospice care.
A big part of hospice is education. We want to do all we can to educate our communities about the services hospice offers and how they can benefit you and your loved ones, starting with some common misconceptions.
Many people think that when they choose hospice, it means they are giving up hope. We have this instinct to fight and fight until the very end, and to stop fighting means to give up. However, hospice isn’t giving up. It is giving yourself and your loved ones permission to stop running back and forth to the hospital and stop the exhausting curative treatments. Hospice allows patients to be comfortable and at peace and to have the best quality of life possible.
Many people believe hospice is a place you must move to when you elect services. This is not the case. Hospice services can be provided wherever you call home – including your residence or a skilled nursing facility. The majority of patients on hospice services live at their home and continue to live at their home throughout their time on hospice.
Another common misconception about hospice is that it will cost you and your family a lot of money. The truth is actually quite the opposite. Hospice does not cost you anything out of pocket. It is covered by Medicare, Medicaid, Veterans’ benefits, and most private insurances.
This includes not only the cost of nursing visits, but also the cost of medications and medical supplies.
Learn more about how hospice is paid for.
The goal of hospice is to keep the patient’s pain under control and to keep them as comfortable as possible. While pain and symptom management can include giving the patient morphine and other comfort medications, not all patients will need it.
Hospice does not expedite death and does not help patients die. In fact, we sometimes find that patients live longer than expected when they choose to receive the support of hospice services. Hospice is about ensuring the patient is no longer suffering from the symptoms of their terminal illness. It keeps them comfortable by managing pain and symptoms, such as shortness of breath or restlessness.
This could not be further from the truth. When you elect hospice, you (or your power of attorney) are always in control. You are in the driver’s seat, and hospice is here to support you. If you decide you no longer want the support of hospice, you can make that decision. And if you are ready for hospice again at a later time, you decide that, too.
Hospice will not tell you what to do. You tell hospice what your care goals are and what you want. If you do not want certain medications, they will not be forced on you. The hospice care team will work with you to honor your wishes in every aspect of your care.
Many people think hospice is only for the very end of a patient’s life, but that’s not the case. Although hospice is for patients who have a life expectancy of six months or less (should the disease run its natural course), you can be on hospice for much longer than that – and many patients are.
Hospice patients are assessed regularly during each benefit period. As long as they continue to meet Medicare criteria, patients can continue to receive hospice support, indefinitely.
You do not have to give up your primary care physician (PCP) when you are admitted to hospice. In fact, your PCP is a very important part of the hospice care team. The hospice team will work with your physician to be sure they are updated on your condition and any changes in your care plan.
It is commonly thought that only cancer patients can receive hospice support. However, hospice is for any patient with any terminal diagnosis. Other common diagnoses of hospice patients are end-stage lung diseases (such as COPD or emphysema), heart disease, kidney disease, Parkinson’s, ALS, Alzheimer’s and other Dementias. Patients who have multiple chronic illnesses, that together result in their health being more fragile, also qualify for hospice services.
These are only some of the most common misconceptions about hospice care. If you are still feeling unsure of whether you or your loved one qualify for hospice or if it’s the right choice for you, please feel free to give us a call. We are happy to answer any questions you may have about the services we provide.
Just because you call, doesn’t mean you have to elect hospice. It never hurts to ask questions and learn more. If it’s not the right time now, maybe it will be later. And by calling now, you’ll have all the information you need to make an informed decision when the time is right.
There are a lot of things to take into consideration when considering hospice for yourself or for someone you love. In our previous blog post, we discussed the important topic of who pays for hospice. Now, we want to talk about who makes up the hospice care team.
It’s a common misconception that you cannot continue to use your primary care physician (PCP) when you choose hospice. This is not true. The patient’s PCP will continue to be as involved in their care as you want them to be, working closely with the hospice team to determine the best care plan options. The hospice team will keep them informed of all the patient’s wants and needs.
A Hospice Medical Director will also be part of the hospice care team. They oversee all clinical aspects of hospice care and provide medical education to community and facility staff. The Medical Director also actively participates in the admission, eligibility, and recertification decisions and provides overall direction to the rest of the hospice team.
Although they receive guidance from the Medical Director, the hospice nurse is the one who manages the patient’s care. The nurse will visit based on a schedule that meets the patient’s individual needs. Their main purpose is to provide pain and symptom management, keeping the patient as comfortable as possible. They will also administer medication as necessary and will tend to any wounds the patient may have.
There is always a hospice nurse on call – 24/7, 365 – to answer any questions that may arise.
A Certified Nursing Assistant (CNA), also referred to as an Aide, plays a pivotal role in the hospice care team. They are trained caregivers who work under the supervision of a registered nurse to assist with personal care and other duties around the home. CNAs will help the patient with things like bathing, dressing, grooming, and feeding. They will also help with light housekeeping.
CNAs also provide education to family/caregivers so they can feel confident in caring for their loved one when hospice is not there. This can include how to safely transfer your loved one from bed to a chair and back or the best way to help them get from room to room.
CNAs provide a special level of care for hospice patients and their family/caregivers.
Dealing with a terminal illness can be delicate and difficult for the patient and family. The hospice social worker is here to provide emotional support for you and your family, as well as to help with things like:
Our pastoral care team is comprised of ordained ministers with various religious affiliations who provide spiritual support to the patient and their family throughout the entire hospice journey. They provide an interfaith forum where the spiritual needs of the individual come first, not the denomination. Services they provide include praying with the patient/family, reading scripture, or even just sitting quietly with the patient. Chaplains can provide or arrange for religious sacraments or other religious rites. They may also help with funeral or memorial service arrangements.
The grieving process doesn’t wait until the patient has passed to begin. It is completely normal to feel grief when facing the impending loss of someone you love. Bereavement coordinators are here for you and your family whenever you need them most. Their support begins at the time the patient is admitted to hospice and continues for up to 13 months after death. Everyone grieves differently, but no one should ever have to go through it alone.
Volunteers are specially trained to support the patient and their family by providing services such as reading, art/music therapy, pet therapy, and so much more. There are also Veteran volunteers for Veteran patients who would like visits from a volunteer who served in the military.
Volunteers can have such a huge impact on a patient’s hospice journey.
The final and most important part of the hospice is care team is you, the patient’s family/caregiver. You will be involved in your loved one’s care every step of the way. Starting from the very first discussion about our services, our team will coordinate with you throughout your entire hospice journey to care for your spouse, parent, or other loved one as though they are our own.
If you’d like to learn more about the hospice care team, please contact us. We are here to answer any questions you may have.
‘Who pays for hospice?’ It’s a very common question. And it’s a very good question. If you are considering hospice care for someone you love (or maybe for yourself), you have a lotof things to think about. Worrying about how you are going to pay for hospice care should not be one of them.
At Apreva Hospice, we strive to provide exceptional care for our patients and their families. This begins with providing education and resources to ensure everyone involved understands what to expect when choosing our hospice services. That being said, we want to dive into how hospice is paid for.
Medicare Part A covers hospice through the Medicare Hospice Benefit, which states you pay nothing for hospice care. To qualify for hospice care, a hospice doctor and your own doctor (if you have one) must certify that you are terminally ill. This means you have a life expectancy of 6 months or less, should the disease run its natural course. When agreeing to hospice, you will sign a statement that confirms you are choosing hospice care rather than other benefits Medicare covers to treat your terminal illness and related conditions. Simply put, you are agreeing that you are choosing comfort care instead of curative treatment.
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. It also pays for hospice care for terminally ill individuals in many states. Similar to Medicare, hospice services through Medicaid include:
To qualify, a hospice provider must obtain a physician certification that a patient is terminally ill, and hospice services must be reasonable and necessary for the management of the terminal illness and related conditions. A hospice plan of care must be established prior to services being provided.
The Department of Veteran Affairs (VA) covers hospice care for Veterans who are in the final phase of their lives. They work closely with community and home hospice agencies to provide care in the home. Since hospice is part of the VHA Standards Medical Benefits package, all enrolled Veterans are eligible for services as long as they meet the clinical need for service.
There are no copays for hospice care, whether it is provided by the VA or an organization with a VA contract.
Many private insurance companies provide some coverage for hospice care. Check with your insurer to determine whether hospice is covered. Qualifications and covered benefits vary based on the private insurer.
If you don’t have insurance coverage and cannot afford hospice care, it may be provided free of charge through financial assistance such as donations, gifts, grants, or other community sources.
Please feel free to contact us if you’d like more information about how hospice care is paid for. Our team is always here to answer any questions you may have.