Frequently Asked Questions about Hospice

The long-term survival of hospice in America depends on a public

that is fully aware of the benefits of hospice and palliative care

services. According to a survey conducted by the National Hospice

Foundation, 75% of Americans do not know that hospice care can be

provided in the home, and 90% did not realize that hospice care can be

fully covered through Medicare. However this survey also showed that

Americans want the kind of end-of-life services offered by hospice.

To learn more about hospice, begin with the following questions and answers.

What are some questions that you should ask when looking for a hospice program?

How can you afford hospice care?

Where does hospice care take place?

How does hospice work?

Who is the hospice “team”?

How does hospice serve patients and families?

What role do volunteers play in hospice care?

Who qualifies for hospice care?

Does hospice only take care of cancer patients?

When is it time to refer a patient to hospice and who does it?

What does the hospice admission process involve?

Does hospice do anything to make death come sooner?

How difficult is it to care for a loved one at home?

Is the home the only place hospice care can be delivered?

How does hospice manage pain?

Hospice provides bereavement care to the family. What does that mean?

FAQ # 1: What are some questions that you should ask when looking for a hospice program?

Hospice care is a philosophy of care that accepts dying as a natural

part of life. When death is inevitable, hospice seeks neither to hasten

nor postpone it. 

FAQ #2: How can you afford hospice care?

Eighty percent of people who use hospice care are over the age of

65, and are thus entitled to the services offered by the Medicare

Hospice Benefit. This benefit covers virtually all aspects of hospice

care with little out-of-pocket expense to the patient or family. As a

result, the financial burdens usually associated with caring for a

terminally ill patient are virtually nonexistent. In addition, most

private health plans and Medicaid in 42 states, including Georgia, and

the District of Columbia cover hospice services.

If coverage is not available, hospice will help investigate other

resources the family may not be aware of. If necessary, most hospices

provide care by using money raised in their community from memorials,

special events, foundation gifts, and other contributions.

FAQ #3: Where does hospice care take place?

The majority of hospice patients are cared for in their own homes or

the homes of a loved one. “Home” may also be broadly construed to

include services provided in nursing homes, hospitals, assisted living

facilities, retirement homes, and even in prisons.

FAQ #4 How does hospice work?

Once a patient selects hospice care, a hospice team is assembled.

The patient, family, and hospice team develop a comprehensive plan that

supports the patient’s decision to remain at home. Each hospice patient

usually has a “primary caregiver.” This caregiver is often the

patient’s spouse, partner, or parent, although any family member or

friend can fill this role. Members of the hospice team visit the

patient and family regularly to provide medical and social services and

to support the caregiver.

In a 1996 Gallup poll, nine out of ten people surveyed said that, if

given six months to live, they would choose to be cared for and die in

their own homes or in those of family members. Hospice care is

available as well in many nursing and rest homes and assisted living

facilities. Some hospices also have in-patient facilities where

patients with acute medical needs are cared for by hospice trained

staff and volunteers.

FAQ #5: Who is the hospice “team”?

The team assembled when a patient selects hospice care includes the

patient and family as well as doctors, nurses, nursing assistants,

social workers, counselors, spiritual caregivers, and volunteers. This

team helps coordinate medications, supplies, equipment, hospital

services, and additional helpers in the home, as appropriate.

FAQ #6: How does hospice serve patients and families?

Hospice care is a family-centered approach that includes, at a

minimum, a team of doctors, nurses, social workers, counselors, and

trained volunteers. They work collaboratively focusing on the dying

patient’s needs, be they physical, psychological, or spiritual. The

goal is to help keep the patient as pain-free and lucid as possible,

with loved ones nearby until death.

Below is a list of services available to Medicare hospice recipients.

Physician services for the medical direction of the patient’s care.

Regular home visits by registered nurses and licensed practical nurses.

Home health aides and homemakers for services such as dressing and bathing.

Social work and counseling.

Medical equipment such as hospital beds.

Medical supplies such as bandages and catheters.

Medications for symptom control and pain relief.

Volunteer support to assist patients and loved ones.

Physical therapy, speech therapy, occupational therapy, and dietary counseling.

FAQ #7: What role do volunteers play in hospice care?

Hospice began as a volunteer-driven service providing care to

patients in their homes. Today, hospice volunteers play a vital part in

the overall care delivery system. From relieving caregivers to running

errands, hospice volunteers work closely with the hospice team to meet

the needs of both the patient and their family.

FAQ #8: Who qualifies for hospice care?

Hospice care is for any person who has a life-threatening or

terminal illness. Most reimbursement sources require a prognosis of six

months or less if the illness runs its normal course. All hospices

consider the patient and family together as the unit of care.

FAQ #9: Does hospice only take care of cancer patients?

No. Patients with both cancer and non-cancer illnesses are eligible

to receive hospice care. Hospice serves those who are at the end-stage

(having a life expectancy of six months or less) of any disease,

although many hospice patients do have cancer. As health care changes

and chronic diseases increase, hospice serves a widening range of

patients. Other people commonly served by hospice include those with

diseases of the heart and lungs, AIDS, ALS (Lou Gehrig’s disease) and

Alzheimer’s.

FAQ #10: When is it time to refer a patient to hospice and who does it?

Any time during a life-limiting illness, it is appropriate to

discuss all of a patient’s care options, including hospice. (People

with life-limiting illnesses may have months versus years to live.) By

law, the decision belongs to the patient. Many people are uncomfortable

with the idea of stopping an all-out effort to “beat” a disease. The

hospice team is sensitive to these concerns and is always available to

discuss them with the patient, family, and physicians.

Some physicians may feel uncomfortable bringing up hospice care, so

a patient or caregiver should feel free to bring up the topic. In

addition to physicians, a patient, friend, family member, or pastor may

make a hospice referral. An early referral enables the hospice team to

develop the relationships that meet the needs of the patient and

caregivers. If the patient continues to meet hospice criteria, services

may continue longer than six months.

FAQ #11: What does the hospice admission process involve?

One of the first things hospice will do is contact the patient’s

physician to make sure he or she agrees that hospice care is

appropriate for the patient at this time. The hospice care goals and

available services will be reviewed carefully with the patient and

caregivers to make sure they are understood. The patient will be asked

to sign consent and insurance forms similar to those signed when

entering a hospital.

FAQ #12: Does hospice do anything to make death come sooner?

Hospice does nothing to hasten or unduly prolong the dying process.

Hospice provides a presence and specialized knowledge during this

particularly difficult time. Hospice services are designed to bring

comfort, to control pain and other symptoms, and to address the

emotional, social, and spiritual needs of both the patient and his or

her loved ones.

FAQ #13: How difficult is it to care for a loved one at home?

While it is never easy, some caregivers have said it was an

especially rewarding period of their lives, a time when they could

express love and caring in a personal and meaningful way. One of the

first things hospice will do is work with the patient and caregivers to

prepare an individualized care plan. The hospice team works closely

with the patient and caregivers to address their needs. The hospice

team visits regularly and is always accessible to answer questions and

provide support. While friends and family give most of the care,

hospices do have volunteers to assist with errands and to provide an

occasional break.

FAQ #14: Is the home the only place hospice care can be delivered?

No.  Although most hospice services are delivered in a private

residence, some patients live in nursing homes, assisted living

facilities, or hospice centers.

FAQ #15: How does hospice manage pain?

Hospice has expertise in managing pain. Hospice staff are up-to-date

on the latest medications and approaches for pain and symptom relief;

they also recognize that emotional and spiritual pain is  just as real.

The hospice team is uniquely skilled at addressing the needs of patients

and their caregivers during this difficult period. With hospice care,

many patients can be as alert and comfortable as they desire.

FAQ #16: Hospice provides bereavement care to the family. What does that mean?

Bereavement care refers to the organized program of grief support

provided by a hospice to caregivers and families. Based on the needs of

the families and caregivers, bereavement care might include individual

counseling, support groups, or informational mailings. Family members

also can call to request additional support any time during the year

following the death of their loved one. In addition, many hospices

sponsor bereavement functions and support groups for the community.