Frequently
Asked Questions About Hospice
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 is appropriate to discuss all of a patients care
options, including hospice. By law the decision belongs to the patient.
Understandably, most people are uncomfortable with the idea of stopping an
all-out effort to beat the disease. Hospice staff members are highly sensitive
to these concerns and always available to discuss them with the patient and
family.
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 Academy of Hospice Physicians; medical
societies; the Indiana Hospice Organization,
4. Can a
hospice patient who shows signs of recovery be returned to regular treatment?
Certainly.
If the patients 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 a 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?
One of the
first things hospice will do is contact the patients physician to make sure he
or she agrees that hospice care is appropriate for this patient at this time.
(Hospices have medical staff available to help patients who have no physician.)
The patient will also be asked to sign consent and insurance forms. 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 for a terminal illness.
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 gets worse. 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 is 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 in your situation. Hospice staff visits regularly and are
always accessible to answer medical questions and provide support.
8. Must
someone be with the patient at all times?
In the
early weeks of care, its usually not necessary for someone to be with the
patient all the time. Later, however, 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?
Its 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 with the family and make night
visits if the need arises. To repeat: Hospice can also provide trained
volunteers to provide respite care, to give family members a break.
10. What
specific assistance does hospice provide home-based patients?
Hospice
patients are cared for by a team of doctors, nurses, social workers,
counselors, home health aides, clergy, therapists, and volunteers -- and each
provides assistance based on his or her area of expertise. In addition,
hospices help provide medications, supplies, equipment, hospital services, and
additional helpers in the home, if and when needed.
11. Does
hospice do anything to make death come sooner?
Hospices do
nothing either to speed up or to slow down the dying process. Just as doctors
and midwives lend support and expertise during the time of child birth, so
hospice provides its presence and specialized knowledge during the dying
process.
12. Is
caring for the patients at home the only place hospice care can be delivered?
No.
Although 90% of hospice patient time is spent in a personal residence, some
patients live in nursing homes or hospice centers.
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, as it addresses 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
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.
14. What
is hospices success rate in battling pain?
Very high.
Using some combination of medications, counseling and therapies, most patients
can be kept pain free and comfortable.
15. Will
medications prevent the patient from being able to talk or know what is
happening?
Usually
not. It is the goal of hospice to allow the patient to be pain free but alert.
By constantly consulting with the patient, hospices have been very successful
in reaching this goal.
16. Is
hospice affiliated with any religious organizations?
Hospice is
not an off-shoot of any religion. While some churches and religions 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
site of beliefs.
17. Is
hospice care covered by insurance?
Hospice
coverage is available widely. It is provided by Medicare nationwide, by
Medicaid in over 30 states, and by most private health insurance policies. To
be sure of coverage, families should, of course, check with their employer or
health insurance provider.
18. If the
patient is eligible for Medicare, will there be any additional expenses to be
paid?
Medicare
covers all services and supplies for the hospice patient. In some hospices, the
patient may be required to pay a 5% or $5 co-payment on medication and respite
care. Hope Hospice of
19. If the
patient is not covered by Medicare or any other health insurance, will hospice
still provide care?
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 for the community or
from memorial gifts, foundation gifts, or grants.
20. Does
the hospice provide any help to the family after the patient dies?
Hospice provides
continuing contact and support for family and friends 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 experienced a death of a
family member, a school friend, and the like.
For
additional information about Hope Hospice, how you may volunteer, how you may
make a donation,
or how the hospice program may serve you, contact:
HOPE HOSPICE
Brenda Purkey, RN, CHPN
Telephone: 574/224-HOPE
E-mail: hospice@rtcol.com