1. When should a decision about entering a hospice program be made and who should make it?
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 aggressive efforts to “beat” the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family. Under Medicare guidelines, hospice care is available to those patients that the doctor believes, if the patient continues to follow the natural disease progression, are likely to expire within 6 months.
2. Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
3. What if our physician doesn’t know about hospice?
Most physicians know about hospice. If your physician wants more information about hospice, it is available from the National Council of Hospice Professionals Physician Section, medical societies, state hospice organizations, or the National Hospice Helpline, 1-800-658-8898. In addition, physicians and all others can also obtain information on hospice from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration.
4. Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
5. What does the hospice admission process involve?
It's easy! All you need is a physician's signature and your loved one can be admitted within an hour. The patient will be asked to sign consents and appropriate admission paperwork. These are similar to the forms patients sign 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.
6. Is there any special equipment or changes I have to make in my home before hospice care begins?
Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. 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.
7. How many family members or friends does it take to care for a patient at home?
There’s no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice staff visits regularly and are always accessible to answer medical questions, provide support, and teach caregivers. Guardian Hospice nurses are available 24/7 to assist with patient care needs.
8. Must someone be with the patient at all times?
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, based upon the changing needs of the patient and since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously.
9. How difficult is caring for a dying loved one at home?
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 by phone with the family and make night visits if appropriate. “Respite care” can be arranged to give family members a break. Arrangements can also be made for inpatient, nursing home or assisted living placement, should the need arise.
10. What specific assistance does hospice provide home-based patients?
Hospice patients are cared for by a team of physicians, nurses, social workers, counselors, hospice certified nursing assistants, clergy, therapists, and volunteers. Each provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and hospital services, related to the terminal illness and additional helpers in the home, if and when needed.
11. Does hospice do anything to make death come sooner?
Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
12. Is caring for the patient at home the only place hospice care can be delivered?
No. Guardian Hospice provides care to patients wherever they are, whether that is a private home, nursing home, assisted living, hospice unit or hospital inpatient setting.
13. How does hospice “manage pain”?
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.
14. What is hospice’s success rate in battling pain?
Very high. Using various combinations of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
15. Will medications prevent the patient from being able to talk or know what’s happening?
Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
16. Is hospice affiliated with any religious organization?
No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
17. How much will Hospice Care Cost?
• Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 39 states, and by most private insurance providers. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
• Medicare covers all services and supplies for the hospice patient related to the terminal illness. In some hospices, the patient may be required to pay a 5% or $5 “co-payment” on medication and a 5% co-payment for respite care. You should find out about any co-payment when selecting a hospice. Guardian Hospice currently does not require a co-payment.
• 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 for anyone who cannot pay using money raised from the community or from memorial or foundation gifts. Guardian Hospice provides indigent care without a limit on the number of indigent patients under service at one time.
18. Does hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for caregivers for at least a year following the death of a loved one. Most hospices also sponsor bereavement groups and support for anyone in the community who has experienced a death of a family member, a friend, or similar losses.
19. Why Choose Guardian Hospice?
• Our Patients will always come first
• Our Hospice Patients are admitted within 1 hr of a Physician Order, 24/7
• Our Patients will be contacted by one of our care providers within 10 minutes
• A dedicated Clinical Compliance Team ensuring Clinical Excellence
Our Home Health Care Division:
• Has provided Home Healthcare for over 35 years
• Served over 100,000 Patients
• Operate out of 41 Offices
• Provide daily care to over 10,000 Patients