Here some basic answers to frequently asked questions about hospice and palliative care:
What is hospice?
Hospice is a philosophy of care, not a specific place. Hospice services are provided to patients wherever they call “home,” whether it’s in a residence, skilled nursing facility or residential care facility.
How does hospice work?
Hospice care is provided to patients with life-limiting illnesses who no longer wish to pursue treatment to cure their disease. The typical hospice patient has a life expectancy of six months or less.
Who makes the decision about entering hospice?
Ultimately the decision is made by the patient, with consultation with his or her physician and the family, during a life-limiting illness. Hospice is available during the decision-making process to discuss all care options.
Who is eligible for hospice care?
Hospice care is provided for all ages, children, adults, and the elderly. A physician must certify that the patient is terminally ill with less than six months to live if the disease takes its expected course.
How is hospice care different?
Hospice treats the person, not the disease. The emphasis is on palliative care, which means the hospice team members, under the direction of a physician, work to help the patient feel more comfortable. The goal is to enable the patient to live as fully and comfortably as possible.
What kind of support is provided the family?
Support of the whole family is an important part of the hospice care plan. Hospice considers the whole family in decision-making, with the patient’s choice as the primary concern for determining care.
What is the hospice interdisciplinary team?
Hospice care is provided by a team of hospice staff members who coordinate efforts on behalf of the patient and family. The team of professionals includes doctors, nurse practitioners, nurses, home health aides, social workers, spiritual counselors, therapists and trained volunteers.
How is the care plan developed for patients?
Both the patient and family are taken into consideration when developing a plan of care for the patient. Typical concerns are pain and symptoms, but the psychological, social and spiritual needs of the patient and family are also addressed.
When is the hospice team available?
Some of the hospice team members are available to offer support and makes visits to the patient and family in their home environment. All hospice programs have a 24-hour telephone call service available seven days a week.
When and how are hospice referrals made?
Referrals are generally made by the primary care physician, but referrals also can be made by family members contacting a hospice directly.
Who pays for hospice care?
Hospice care is fully reimbursed by Medicare and often by Medicaid (dependent upon state policy). Most other health plans and private insurances cover hospice services fully, but some may require that the deductible be met and/or may have a co-payment.
What is the Medicare Hospice Benefit?
To be eligible for Medicare reimbursement of hospice care, a physician must certify that the patient has less that six month to live if the disease runs its normal course. The patient signs an elective statement indicating he or she understands the nature of the illness and of hospice care.
How is palliative care different than hospice care?
Palliative care extends the principles of hospice care to a broader population that could benefit from receiving this type of care earlier in their illness or in the disease process, the National Hospice & Palliative Care Organization explains on its website. No specific therapy is excluded from consideration.
What is the role of the team working with patients involved with a palliative care program?
NHPCO writes: “An individual’s needs must be continually assessed and treatment options should be explored and evaluated in the context of the individual’s values and symptoms. Palliative care, ideally, would segue into hospice care as the disease progresses.”