Frequently Asked Questions

When should a decision about entering a hospice program be made--and who should make it?
By law, the decision belongs to the patient. However, at any time during a life-limiting illness, it is appropriate to discuss all of a patient's care options, including hospice. Most people are uncomfortable with the idea of stopping an all-out effort to "beat" their disease, but our hospice staff members are sensitive to these concerns and are available to discuss them with the patient, family, and physician.

Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
The patient and family should discuss hospice care at anytime with their physician, other healthcare professionals, clergy or friends.

What if our physician is not familiar with hospice?
Most physicians know about hospice. If your physician wants more information, it's available from the American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local hospices, or the National Hospice Help Line, 1-800-658-8898.

Information on hospice can also be obtained from the American Cancer Society, the American Association of Retired Persons and the Social Security Administration.

Can a hospice patient who shows signs of recovery return to regular medical treatment?
Certainly. If improvement occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive therapy or go on about his or her 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.

What does the hospice admission process involve?
One of the first things hospice will do is contact the patient's physician to be sure they agree that hospice care is appropriate for this patient at this time. (In many cases, hospices may have medical staff available to help patients who have no physicians.) The patient will be asked to sign consent and insurance forms, which are similar to the forms they sign when they enter a hospital. The so-called "hospice election form" states that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative, and outlines the services available. The Medicare form patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.

Is there any special equipment or changes I have to make in my home before care begins?
Your hospice provider will assess your needs, recommend any necessary equipment, and help make arrangements to obtain it. Often the need for equipment is minimal at first, but 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.

How many family members or friends does it take to care fora patient at home?
There's no set number. One of the first things a hospice team does is prepare an individualized care plan that will, among other things, address the amount of caregiving a patient needs. Members of the hospice staff visits regularly and is accessible to answer questions and provide support.

Must someone be with the patient at all times?
In early weeks of care, it's usually not necessary for someone to be with the patient at all times. Since one of the most common fears of patients is the fear of dying alone, however, our hospice generally recommends someone to be there continuously in the later stages of treatment. While family and friends must be relied upon to give most of the care, our hospice does provide volunteers to assist with errands and to provide a break and time away for major caregivers.

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 particularly can be very long, lonely, and scary. For that reason, our hospice has staff available around the clock to consult with the family and to make night visits as appropriate.

What specific assistance does hospice provide home-based patients?
Our hospice patients are cared for by a team of doctors, nurses, social workers, counselor, home healthy aides, clergy, therapist, and volunteers-and each provided 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, as appropriate.

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 childbirth, so hospice provides its presence and specialized knowledge during the dying process.

Is the home the only place hospice care can be delivered?
No. Although most hospice services are delivered in a personal residence, some patients live in nursing homes or hospice centers.

How does hospice "manage pain"?
Our 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, diet counseling, and other therapies.

Our hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these, as well. Counselors, including clergy, are available to assist family members as well as patients.

What is hospice's success rate in battling pain?
Very high. Using some combination of medications, counseling, and therapies, most patients can attain a level of comfort that is acceptable to them.

Will medications prevent the patient from being able to talk or know what's happening?
Usually not. It is the goal of our hospice to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, our hospice has been very successful in reaching this goal.

Is hospice affiliated with any religious organization?
Hospice care - as a rule - is not an off-shoot of any religion. While some religious organizations 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.

Is hospice care covered by insurance?
Hospice coverage is widely available. It is covered by Medicare nationwide, by Medic-aid in some 42 states, and by most private insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?
The first thing our 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 care for those who cannot pay, using money raised from the communityou*' from memorial or foundation gifts.

Does 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 and support groups for anyone in the community who has experienced the death of a family member, a friend, or a loved one.

If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Medicare covers all services and supplies related to the terminal illness for the hospice patient. In some hospices, the patient may be required to pay a 5% or $5 "co-payment" on medications and a 5% co-payment for respite care. You should find out about any co-payment when choosing a hospice.