Hospice is a philosophy and delivery of care for patients with a terminal illness who have a life expectancy of six months or less and who choose not to seek (or to discontinue) treatment to cure their illness. The goal of hospice care is to make the patient as comfortable as possible by relieving pain and symptoms of the disease and to support the patient and family emotionally and spiritually during the final months of life.
It is best for family members to share their wishes regarding end of life decisions long before it becomes an immediate concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients and families 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.
While it’s true that hospice care is for patients with 6 months to live or less, we do not view the decision to pursue hospice care as “giving up.” Rather, we see it as a way of saying yes to maintaining an element of control and living each day to the fullest. Time and time again, patients and families tell us that they wish they sought the resources of hospice care much sooner in the process.
Hospice care takes place in the home.
For some, “home” may mean a house or an apartment. For others, it may be some form of extended care facility, such as a nursing home or assisted living community. Regardless of your circumstance, Center for Hospice Care team will come to you where you live in NL County.
The majority of hospice patients live in their own home with the help of a family member or friend who serves as the “primary caregiver.” This caregiver works closely with the hospice team to provide for the patient’s daily needs. In extended care facilities, hospice teams create a partnership with the staff and family, just as they would with the family in the home.
Even if you move to another town or state, Center for Hospice can make arrangements for you to receive hospice care from the provider in your new location.
In addition to home care, hospice provides short-term inpatient hospital care when necessary to manage the symptoms of the illness. During these times, the hospice team remains involved and helps the patient transition back to the home environment as quickly as possible.
We offer a family-centered approach that includes at minimum, an interdisciplinary group of doctors, nurses, social workers, hospice aides, spiritual counselors, bereavement counselors, pharmacists and trained volunteers. They work collaboratively focusing on the patient’s needs: physical, psychosocial or spiritual. The goal is to help keep the patient as pain free and lucid as possible, with loved ones nearby until death.
Not necessarily. The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy, or friends.
No. Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another. To find the best hospice for your needs, ask your doctor, healthcare professionals, clergy, social workers or friends who have received care for a family member.
One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient. The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.
Our services can be provided to a terminally ill person wherever he or she lives. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, hospice aides, chaplains, social workers, and volunteers, in addition to other services provided by the nursing facility. Center for Hospice Care and the nursing home will have a written agreement in place for the hospice to serve residents of the facility. Care within a facility is dependent upon insurance coverage.
Beyond medical care, we provide supplies, equipment, around-the-clock communications, and other services related to the terminal illness.
We 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 progresses. In general, we will assist in any way we can to make home care as convenient, clean, and safe as possible.
There’s no set number. One of the first things we will do is prepare an individualized care plan that will address the amount of caregiving needed by the patient. This will define how many primary caregivers (family/friends) are required, and how much support is required from Center for Hospice Care. Our staff will then visit regularly and are always accessible to answer medical questions.
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. In later weeks we generally recommend that someone be there continuously. While family and friends do deliver most of the care, we often use volunteers to assist with errands and to provide a break for primary caregivers.
Our staff is on call for emergencies or concerns 24 hours a day, 7 days a week, 365 days a year. If you require more care than can be provided in the home, skilled nursing homes are often an option.
Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. They make sure medications, therapies and procedures are designed to achieve the goals outlined in the patient’s plan of care. We also offer Counseling services and Bereavement services to address the emotional difficulties faced by patients and loved ones.
Very high. Using a combination of medications, counseling, and related therapies, most patients can attain a level of comfort they consider acceptable.
Usually not. It is our goal to have the patient as pain free and alert as possible. By constantly consulting with the patient, we have been very successful in reaching this goal.
Center for Hospice Care neither hastens nor postpones dying. We only provide resources, services, care, understanding, and deep experience to maximize the quality of the time remaining.
The choice to receive hospice care does not replace your relationship with your doctor. We work directly with the patient’s primary physician and encourage patients to continue to see their doctor as they wish. Under Medicare, patients receive all treatment for the illness for which they were admitted to hospice from their doctor and the hospice team. Patients are free to continue treatments for other medical conditions, and still use their Medicare benefits.
Certainly. If the patient’s 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 the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
No. Hospice patients are certified by the Hospice Medical Directors and Primary Care Physician for periods of care. Once a period of care ends, the doctor can Medical Directors recertify the individual for further hospice care if they are still eligible. For example, under Medicare, a patient can be certified for two ninety day periods, followed by an unlimited number of sixty day periods. As long as the doctor certifies that the person needs hospice care, he or she will continue to receive it.
You may talk to the patient’s doctor and ask if a hospice referral can be made, or you can call us and make the referral yourself. The hospice intake staff will contact the physician to verify appropriateness. Most eligible patients are enrolled within 24 hours of the first call.
Yes, coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 47 states, and by most private insurance providers. To be sure of coverage, families should check with the appropriate health insurance provider. We can provide help with these questions as well.
The Medicare Hospice Benefit covers the full scope of medical and support services related to the life-limiting illness. Hospice services also extend to the family and loved ones. There is little expense to the patient or family.
The first thing we will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, the Center for Hospice Care will not turn away any patient living in a private residence based on the inability to pay.
For patients living at home, “respite” allows family caregivers to take a break from their care giving responsibilities. Depending on your insurance, the family may receive up to five consecutive days for respite care. There is usually a cost sharing for this level of care.
A member of Center for Hospice Care team will notify the patient’s physician and the funeral home. There is no need to contact emergency medical services, the police, or any other service. We will be there to take care of these things as needed.
No. Center for Hospice Care provides continuing contact and support for survivors and caregivers for 13 months following the death of a loved one. We also sponsor bereavement groups for anyone in the community who has experienced the death of a family member, a friend, or a similar loss – free of charge and regardless of whether the loss occurred under our care.
We use research to get feedback on the performance of our programs. We also use the National Hospice and Palliative Care Organization’s “Standards of Practice for Hospice Programs” as another way of ensuring consistent quality.
There are also voluntary accreditation organizations that evaluate hospice programs to protect consumers. These organizations survey hospices to see whether they are providing care that meets defined quality standards. These reviews consider the policies and procedures, medical records, personal records, and evaluation studies of the organization. They also include visits to a sample of patients and families currently under care of that hospice program.
Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.
