FREQUENTLY ASKED QUESTIONS (OR FAQS?) ABOUT HOSPICE
WHEN IS THE RIGHT TIME TO ASK ABOUT HOSPICE?
NOW is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes, long before the immediate need. By having advanced discussions, patients are not forced into uncomfortable “last minute” decisions. This way, patients and their loved ones can talk and make educated choices, so they can plan to make important care decisions together.
HOW DOES HOSPICE CARE BEGIN?
Typically, hospice care starts as soon as a formal request, or a ‘referral’ is made by the patient’s doctor. A hospice program representative will make every effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral, but in urgent situations, hospice services may begin sooner.
WILL I BE THE ONLY HOSPICE PATIENT THAT THE HOSPICE STAFF SERVES?
Every hospice patient has access to a registered nurse, social worker, home health aide, hospice volunteer, and chaplain; also known as the Interdisciplinary Team. For each patient and family, the Interdisciplinary Team develops, utilizes and ensures a Care Plan with the patient/family.
All visits are based on the patient and family needs, as described in the Care Plan, and the patient’s condition during the course of illness. The frequency of volunteers and spiritual care is often dependent upon family request, and availability.
IS HOSPICE AVAILABLE “AFTER HOURS”?
Hospice care is available seven days a week, 24-hours-a-day and “on-call’ after the Administrative Office is closed. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well.
HOW DOES HOSPICE WORK TO KEEP THE PATIENT COMFORTABLE?
Many patients may have pain and other serious symptoms, as illness progresses. Hospice staff receive special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. Because keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice. Hospice staff works with the patient’s physician to ensure that medication, therapies, and procedures are designed and implemented to achieve the patient’s outlined Care Plan goals. The Care Plan is frequently reviewed for changes, or new goals.
WHAT ROLE DOES THE HOSPICE VOLUNTEER SERVE?
Hospice volunteers are generally available to provide many kinds of support to patients and family, including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship.
Hospice programs have an organized training program for patient care volunteers. Training program modules include understanding hospice, confidentiality, family interaction, listening skills, signs and symptoms of approaching death, loss and grief, and bereavement support.
Because hospice volunteers spend time in patients’ and families’ homes, each hospice program has an application and interview process to assure the patient and volunteer are a “good fit”.
CAN I BE CARED FOR BY HOSPICE IF I RESIDE IN A NURSING FACILITY, OR OTHER TYPE OF LONG-TERM CARE FACILITY?
Hospice services can be provided to a terminally ill person, wherever they live. A patient living in a nursing, assisted living, or other long-term care facility can receive specialized visits from hospice nurses, home health aides, social workers, chaplains, social workers, and volunteers, in addition to the facility’s regular care services. Hospice and the nursing home or assisted living care residence have a written agreement for the patient, in place.
WHAT HAPPENS IF I NEED MORE SKILLED CARE AND CAN NO LONGER STAY IN MY OWN HOME DURING THE FINAL PHASE OF MY LIFE?
For patients who can no longer remain in their own home due to increased skilled care needs, a growing number of hospice programs have their own hospice facilities, or have arrangements with freestanding hospice houses, hospitals or inpatient residential centers. However, room and board charges in these settings are not covered under the Medicare or Medicaid Hospice Benefit. It is best to inquire in advance, if insurance or any other pay entity covers this type of care. Most insurance providers have a Hospice Clause to cover the cost of 24-hour skilled care, necessary medical equipment, and medications associated with the hospice diagnosis.
DO STATE AND FEDERAL REVIEWERS INSPECT AND EVALUATE A HOSPICE?
Yes. Hospice programs must meet state licensure requirements to deliver care. Hospices must periodically undergo inspection to ensure they meet regulatory standards to maintain their operating license, and certification that permits Medicare reimbursement.
HOW CAN I BE SURE THAT QUALITY HOSPICE CARE IS PROVIDED?
Many hospices use evaluation methods which allow them to qualify and quantify excellence, in meeting hospice quality and performance standards. In addition, most programs use family satisfaction surveys for program performance feedback. The National Hospice and Palliative Care Organization has developed “Standards of Practice for Hospice Programs” to ensure quality control. There are also accreditation organizations that voluntarily evaluate hospice programs for consumers, reviewing policies and procedures, medical records, personnel records, evaluation studies, and in many cases include patient and family visitations. A hospice program may also volunteer to obtain accreditation from one of these organizations.