Hospice Care

Hospice care is end of life care, typically prescribed by a physician. Unlike palliative care, which can run concurrent with curative treatments, this type of care focuses instead on improving the patient’s comfort and quality of life, while reducing pain during their remaining time. In addition to physical aid, it often includes emotional and spiritual support for both the patient and their family.

Hospice services can be provided in the patient’s home, or in a residential hospice facility, hospital, nursing home, assisted living, or other long-term care community.

Hospice care in the home can be given for the duration of the terminal patient’s life (after a referral from a doctor is attained), or just during the times when the patient has a crisis and requires more care than their family member or caregiver can provide. Respite care is a level of care provided and paid for by hospice when the regular caregiver needs a break or can’t cope with the situation.

Hospice care in a residential hospice facility may be provided when the patient’s symptoms can no longer be controlled at home.

Hospice care at a long-term care community can be given throughout the duration of the patient’s life, after the doctor’s recommendation.

When an individual requires hospice care, an entire team is typically assigned to work with the patient and their caregiver or family member. They develop an individualized care plan to help control any symptoms and/or pain, and to provide the patient with any emotional or spiritual support they need. Family members are often expected to be part of the patient’s personal care plan which is supplemented by professionals, not completely provided for by professionals.

The hospice team often consists of:

• Family members
• The regular caregiver(s)
• Personal physician
• A hospice doctor
• Nurses
• Home health aides
• Medical social workers
• Bereavement counselors
• Chaplains

The hospice team will make regular visits to check on the patient, and to provide additional care or other services as needed. Members of the team are generally on call 24 hours a day. This applies whether services are being received at home or in a facility.

Hospice care is covered by Medicare, Medicaid, and private insurance (sometimes with a co-pay), based on individual needs. Under Medicare, hospice care covers most medications, medical equipment, around-the-clock access to care, nursing, social services and grief support, and potentially other services deemed necessary based on the patient’s unique needs. Hospice care may provide companion care through a volunteer program, but doesn’t typically provide home care.

Services

Care will vary based on individual needs determined by the hospice team, and as written in the customized care plan. However, hospice care generally includes the following:

• Physician services
• Regular visits by registered nurses and licensed practical nurses to provide care and monitor the patient’s condition
• Home health aide and homemaker services (limited) to tend to personal needs
• Chaplain services for both the patient and family
• Social work and counseling services
• Grief counseling for family and friends
• Medical equipment, often including a hospital bed
• Medical supplies like catheters
• Medications to control symptoms and pain
• Volunteer support
• Alternative therapies like music therapy

Consider these statements below for yourself or on behalf of your loved one:

The costs of hospice care are typically covered based on the following four levels established by Medicare:

• Routine Home Care: This end-of-life care is provided when the patient’s symptoms are under control at their place of residence, whether they are living in their own private home or any type of long-term care community.
• On-Call Service or Care: Provided for short periods of time when the patient experiences a medical or psychosocial crisis.
• Inpatient Respite Care: This care is offered when the family or other caregiver needs a break. The patient can be temporarily placed in a hospice facility for up to five days.
• General Inpatient Care: This type of care is given by hospice centers, hospitals, and nursing homes when the patient’s symptoms can no longer be controlled at home.