What is Hospice Care?

Hospice is not a place. It’s a concept of care. The majority of hospice care is provided in the patient’s home, the home of a loved one, or in a contracted nursing home or assisted living facility. Specially trained medical professionals deliver the care. Their goal is to reduce the patient’s pain and control their symptoms, resulting in improved quality of remaining life. Hospice care also includes support for the emotional and spiritual needs of the patient and their loved ones.

Some of the ways that hospice is different from standard medical care are:

Hospice looks at all the patient’s and family’s needs. A coordinated team of hospice professionals, assisted by volunteers, works to meet the patient’s and family’s emotional and spiritual needs, as well as the patient’s physical needs.

The emphasis is on controlling pain and symptoms through the most advanced techniques available and on emotional and spiritual support tailored to the needs of the patient and family.

Hospice recognizes that a serious illness affects the entire family as well as the person who is ill. The family, not just the patient, is the “unit of care” for hospice professionals. Sometimes other family members actually need more attention than the patient.

Who is eligible for Hospice Care?

The patient’s physician and the hospice’s Medical Director must certify that the patient has a life-limiting illness with a life expectancy of six months or less should the disease run its normal course. The patient chooses to receive comfort care for pain and symptom management rather than curative treatment and agrees with the philosophy of allowing death to occur naturally without extraordinary intervention. The patient will make arrangements for a capable caregiver, and reside in the geographic area served by the desired hospice.

When should patients and families consider Hospice?

Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones. A patient does not have to be critically ill or bed-bound to be admitted to hospice. A hospice representative would be happy to talk with you or your family about the hospice option.

Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by either a healthcare professional or a family member or friend of the patient. Our hospice program representative will schedule a visit that meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin the day of the referral.

What services does Hospice provide?

Hospice includes the services of an interdisciplinary team of health care professionals:

Physicians (the patient’s own physician and the hospice physicians, who are specialist in controlling pain and other symptoms of serious illness) prescribe medications and other methods of pain and symptom control.

Nurses are experts at maintaining patient comfort. They assess the patient frequently and help family members provide the necessary support.

Certified nurse assistants and home health aides provide personal care and help the patient and family with activities of daily living. They also provide companionship and valuable emotional support.

Social workers coordinate community resources and help the patient and family with non-medical concerns. They can help family members mend damaged relationships, plan for the future and ease other emotional difficulties.

Chaplains and spiritual counselors help patients and families cope with spiritual questions and concerns at the end of life, either directly or by coordinating services with the patient’s and family’s spiritual advisors.

Bereavement coordinators help patients and families deal with grief. Grief support services continue for at least one year after the death of a hospice patient.

Volunteers provide companionship and emotional support and offer help in myriad ways.

Hospice also provides medications, medical equipment and supplies necessary to promote comfort at home or in other hospice settings.

Hospice staff are available by phone at all times, 24 hours a day, 365 days a year.

Where is Hospice Care provided?

Hospice care is provided in the patient’s home; in a long-term care facility or assisted living facility if the patient resides there; or a hospice inpatient facility if the patient’s condition necessitates inpatient facility care.

Hospice Care of Middletown offers all of the benefits of hospice care to residents staying in a residential care facility, assisted living facility, intermediate care or skilled nursing facility. Hospice staff members provide instruction to the resident, his or her family, and the facility staff to ensure the resident’s comfort. Hospice care complements services provided by senior living home staff by providing additional nurses, home health aides, social workers, spiritual care and volunteer services. Hospice team members attend care planning meetings at the senior living home to coordinate the plan of care with the staff and family. However, when hospice care is provided in a nursing facility or assisted living facility, the hospice benefit does not pay for the facility’s daily Room & Board for the patient.

Who pays for Hospice Care?

The cost of hospice care is paid by Medicare, Medicaid, and many private insurance plans, with few out-of-pocket expenses for the patient. Hospice care can be provided in an extended care setting such as a nursing home or assisted living facility. The cost of hospice care is covered under the patient’s hospice benefit plan, while room and board charges continue to be paid by Medicaid, private insurance, or private pay.

Thanks to the generous support of donors and volunteers in our community, Hospice Care of Middletown does not turn anyone away due to the inability to pay for hospice services.

What if my condition improves?

Occasionally, the quality of care provided by hospice leads to substantially improved health, and life expectancy exceeds six months. When this happens, the hospice provider will transfer care to a non-hospice care provider. Later, when patients become eligible for hospice, they can re-elect the hospice benefit.

What kinds of emotional and spiritual support does Hospice provide?

Hospice recognizes that people are more than a collection of symptoms. People nearing the end of their lives often face an enormous emotional and spiritual distress. They are dismayed as their physical abilities begin to fail. They don’t want to be a burden on their families. They worry how their loved ones will manage without them. Sometimes, they feel deep regret about things they have done or said – or things left undone and unsaid. Hospice professionals and volunteers are trained to be active listeners and to help patients and families work through some of these concerns so that they can find peace and emotional comfort in their final days.