Hospice 101

What is hospice?

Hospice provides medical care for a terminally ill patient who has a prognosis of six months or less to live. Hospice also provides care and support for the patient’s family before and after death. The focus of hospice care shifts from curative treatment to providing care that maintains patient comfort during their final months.

Who provides hospice care?

Hospice is a unique part of the healthcare continuum as the care is provided by an interdisciplinary team, with the patient or legal representative guiding the goals of care. The interdisciplinary team involves a team of medical experts including: the patient’s primary physician, a hospice physician, nurses, home health aides, social workers, chaplains, volunteers, and therapists.

Where is hospice care provided?

Hospice care is not a place, but rather a philosophy. The patient receives hospice care wherever they are – hospital, nursing home, assisted or supportive living community, home, or hospice house.

Is hospice care expensive?

Hospice is covered by Medicare and Medicaid, and most private insurance companies have a provision for this type of care. The hospice benefit provides for hospice related pharmaceuticals, medical equipment, 24-hour access to medical care, and bereavement support.

What services are provided in hospice?

Hospice provides nursing visits, personal care and psychosocial support, as well as pain management, medical supplies, counseling, and other therapies needed for the terminally ill patient.

When is the right time to begin hospice care?

A patient is appropriate for hospice care when two physicians certify the patient has a life expectancy of six months or less. Often times a patient displays signs of physical or functional decline such as: increased shortness of breath, weight loss, decreased ability to perform activities of daily living, pain, and recurrent hospitalizations. Family may notice the patient is no longer able to return to baseline functioning after hospitalization, which is indicative of chronic decline. Patient eligibility is reassessed at regular intervals, but there is no limit to the amount of time a patient can spend under hospice care.

What care options are available to meet the patient’s and family’s needs?

Hospice care is offered in four levels of care (as defined by the Medicare benefit): routine home care, continuous care, inpatient care, and respite care.

  • Routine home care – Most hospice care is provided at this level. Care is provided in the patient’s home, long-term care facility, and assisted or supportive living community.
  • General inpatient care – If a patient’s needs cannot be met at home, inpatient hospice units or community facility contracts can be utilized to provide round the clock care until the patient’s symptoms are manageable.
  • Respite care – Respite care provides relief for the patient’s primary caregiver by admitting the patient to a community facility for up to five consecutive days without the acute symptom management criteria.
  • Continuous care – When medically necessary, acute symptom management is provided in the patient’s home by hospice staff in shifts up to 24 hours/day so the patient can avoid hospitalization.