Hospice is a way to care for people who are terminally ill by focusing on pain relief and symptom management. Instead of trying to cure the disease, hospice intends to provide comfort to the patient and the family. It provides support for emotional and spiritual end-of-life issues, and focuses on giving seriously ill patients and their loved ones meaningful time together.

It means you have decided that pursuing aggressive or curative care is not a primary option. Generally, a physician determines that a patient’s life expectancy is six months or less; most medical treatments and interventions are no longer effective, will not cure the disease and/or will prolong suffering. The hospice team will focus on pain, symptom management, and comfort care to ensure quality of life is reached.

Anyone can request a hospice evaluation at no cost. Sometimes the physician makes the referral or provides several options and lets the patient/family decide. The physician must certify to the hospice provider that the patient is eligible and has a prognosis of 6 months or less. When a referral is made, the hospice provider makes an appointment to meet with the patient and family. If the discussion goes well and the family is ready to decide, they sign admissions paperwork and the hospice team begins to visit. The admissions nurse evaluates the patient, answers the family’s questions and creates a plan of care that reflects the patient/family’s wishes. Hospice support, and care begins.

Hospice patients receive services from an “interdisciplinary” team, meaning members come from different disciplines or fields. They may include a physician, registered nurse, hospice aide, social worker, chaplain, bereavement services manager, volunteer and other healthcare professionals.

Hospice services are typically received in the patient preferred place of residence. That could be a private residence, assisted living community, or nursing home. Patients can also receive hospice services while in the hospital, or in an inpatient hospice unit.

Levels of care are based on the patient’s specific needs and will be designated by hospice physician.

Medicare requires all hospice agencies to provide the following four levels of care.

Routine Care in the home. Provides visits based on the patients needs.

Continuous Care shifts of acute symptom management to the patient’s bedside for up to 24 hours/day per Medicare guidelines.

General In-Patient Care is provided in a nursing home or hospital and is used for crisis or symptom management. A nurse will provide daily visits and additional support.

Respite Care is typically used for family or caregiver relief for up to 5 days. Patient is placed in a nursing home and after 5 days returns to preferred residence for care.

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No. When treatment options for a disease have been exhausted or no longer work, hospice provides a way for people to live in comfort, peace and dignity without curative care. Hospice isn’t about giving up, but about improving the quality of the patient’s life by being free of pain, surrounded by family and in the comfort of home.

Hospice services can begin when a doctor decides the patient’s life expectancy is six months or less. Patients should consider hospice services when medical treatments can no longer cure their disease and/or symptom burden outweighs the benefits of treatment.

The hospice nurse creates a plan of care with the patient’s and family’s input, designed to meet the patient’s needs. This determines the frequency of visits by interdisciplinary team: Nurse, Social Worker, Spiritual Counselor, Home Health Aide, and Physician.

Yes. Hospice physicians and team members work with your doctor to ensure your clinical and emotional needs are being met and that your care is being carried out appropriately. Your doctor chooses his or her level of participation in your care. They can also be the attending Hospice Physician.

Yes. Family input is important and is the driving force behind developing the most effective plan of care for your loved one.

The hospice plan of care is individualized to meet each patient’s needs. If special equipment (wheelchair, lift, trapeze bar, etc.) or therapies (respiratory therapy, physical therapy, etc.) are needed, the hospice provider offers these as part of its services. Other needs such as, religious practice, cultural traditions, various languages will be addressed. The hospice team will make every effort to ensure needs are met.

Hospice can provide the necessary equipment for the patient's care plan. Hospice patients may need oxygen, a special lift for over the bed, a bedside commode, incontinence supplies or medications that are related to their terminal disease. Medications, supplies and “durable medical equipment” are part of the hospice team’s plan of care for the patient, and should be provided at no cost. Because the family is part of the hospice team, they should be included in discussions of the plan of care and what the hospice patient needs to be comfortable. Any pharmacy, supplies, or medical equipment not related or approved for hospice diagnosis will be discussed.

You will always receive updates on your loved one’s condition. The primary hospice nurse can answer any questions you have, tell you about your loved one’s care and progress, and prepare you for what to expect.

Hospice and home health have similarities but differ in their primary goals of care. Home health is considered episodic care, and is used to help the patient become more independent. Their visits decrease in frequency as the patient’s condition improves.

The goal of hospice is to keep the patient comfortable as the disease progresses. Visits will be tailored based on your loved one’s needs. Supplies, pharmacy and medical equipment will be provided to ensure comfort.

Hospice can provide additional support. Nursing homes focus on routine daily care and rehabilitation. Nursing home residents who receive hospice services get additional, customized support. This is determined by the plan of care, which focuses on the physical, emotional and spiritual end-of-life needs of patients and their families. The hospice will collaborate with nursing home staff to ensure needs are met.

Hospice is for anyone with a terminal disease, regardless of age. Hospice offers quality of life as well as, support for those who are caring for the patient.