What is Hospice Care?
- Who qualifies for hospice care?
- When is hospice needed?
- How does hospice work?
- When is the right time to ask about hospice?
- How is hospice paid for, and what is covered?
- Are all hospices the same?
- What are Advanced Directives?
- Do I need a Do Not Resuscitate (DNR) order to be on hospice?
- Can I be cared for anywhere besides my home?
- Can a hospice patient continue with his or her own doctor?
- Will there be any special equipment or changes made in my home when hospice begins?
- If I choose hospice, does that mean I am “giving up”?
Hospice is about hope; the hope that even in the last stages of incurable disease, life still has meaning and purpose. To choose hospice does not mean giving up and simply waiting to die. Rather, it means securing the appropriate and skilled care that enables a patient and their family to live life as fully and comfortably as possible during the time that remains. Hospice philosophy acknowledges dying as part of a natural process to be neither hastened nor postponed. And when death does come, hospice continues to be there to support family and friends in their grief.
Who qualifies for hospice care?
Any individual may choose comfort care when curative treatment options are limited or become ineffective, when life expectancy is limited and you want to be at “home”. Although no one can predict with certainty when death will come, hospice serves patients with serious advanced illness or health decline resulting in a life expectancy of six months or less if the disease runs it's natural course. Many life-limiting illnesses may be considered appropriate for hospice services beyond the diagnosis of cancer. Advanced Alzheimers or end stage dementia, lung disease, cardiac disease and liver disease as well as a diagnosis of Debility Unspecified often present with symptoms which can no longer be aggressively treated and comfort care may be an option to enhance the quality of a person's life.
When is hospice needed?
At any time during a life-limiting illness, it is appropriate to discuss the option for hospice care. There is no fixed limit on the amount of time a person may continue to receive hospice services as long as they continue to meet the criteria and their doctor is in agreement. Most people have some difficulty discussing end-of-life issues and planning, however, the sooner you discuss hospice with your family, friends and health care providers, the more assistance, comfort and care you and your caregivers receive from our specialized team.
How does hospice work?
Referrals and information requests come from our patients, family members, physicians, healthcare workers, and friends. Hospice team members often make an informational visit to explain about our services and answer questions families or individuals may have. If there is agreement from both the patient and their private physician that hospice is appropriate, services can usually begin as soon as the patient and/or family have given written permission. The admitting nurse and social worker complete their assessments and consult with you and your physician to develop a plan of care.
When is the right time to ask about hospice?
The sooner the information about hospice is sought; the more opportunity exists to provide our comprehensive range of services. Although it is difficult to talk about end-of-life care, opening a conversation with family members to share your wishes in advance can greatly reduce stress long before hospice may be needed. In this way, individuals and family members can make an educated decision and not be forced into uncomfortable situations during a time of crisis.
How is hospice paid for, and what is covered?
Most insurance companies recognize the benefits of hospice care and will reimburse the hospice for its services. Medicare Part A, MassHealth / Medicaid, HMO's, and most private insurances will generally cover all of the hospice services.
These services include:
- Physician Services
- Nursing Care
- Medical Equipment & Supplies
- Medications related to the terminal diagnosis
- Short Term Respite Care
- Home Health Aide
- Social Work and Bereavement
- Physical, Occupational and Speech Therapy, Dietary Counseling when necessary
The hospice staff will assist patients and families in determining specific hospice insurance benefits. Our service is available to any eligible person regardless of ability to pay.
Are all hospices the same?
Hospice of Franklin County offers a breadth of services and depth of experience in providing end-of-life care. When making decisions about the choice of a hospice, important factors to consider are the comprehensive nature of the services, the expertise and training of the staff and availability of additional supportive care for the family such as volunteer and bereavement support. Many of our team members have been providing hospice care in this community for over 20 years.
What are Advanced Directives?
Advanced directives are legal documents that allow a person to make their own decisions or wishes about their medical care known ahead of time in the event they should ever become unable to communicate. These written instructions, often called a Living Will, can include what your preferences for treatment would be if you were entering the end stage of your life. In the state of Massachusetts, you have the right to choose a Health Care Proxy who is someone you trust and appoint as a surrogate to make decisions about your medical care for you if you are unable to communicate and make decisions for yourself. It is important to plan ahead and communicate your personal preferences for treatment to those closest to you as well as your physician. Conversations before a crisis can help guide family members who may someday be making difficult decisions about the kind of health care you would want.
Do I need a Do Not Resuscitate (DNR) order to be on hospice?
Individuals receiving hospice care do not need to have a Do Not Resuscitate (DNR) order at the time of admission to our program. In most instances, individuals recognize their condition has deteriorated and then decide they do not want any form of life prolonging procedures such as CPR. Hospice of Franklin County will work with the individual, their family and physician to insure their wishes are honored.
Can I be cared for anywhere besides my home?
Hospice of Franklin County services can be provided to a person with a life-limiting illness wherever they live. Our care is available in your home, rest homes, assisted living programs and long term care facilities and hospitals. In nursing homes, hospice works closely with the facility staff and family to coordinate the patient's physical, emotional, and spiritual care. Combining the expertise of the long-term care nursing home facility staff with that of the hospice team provides an opportunity to offer a level of supportive care neither organization could provide alone.
Hospice nursing home services follow guidelines established by the Medicare and Medicaid programs.
Can a hospice patient continue with his or her own doctor?
Absolutely! Your physician will remain fully involved in all aspects of your care. Decisions about all your medical needs including pain and symptom management, are directed by your primary care physician in consultation with the hospice team.
Will there be any special equipment or changes made in my home when hospice begins?
The Hospice of Franklin County team will assess your needs, recommend any equipment such as a shower chair, walker, or specialized mattress and arrange to have these items delivered to your home. It is always your decision to accept or decline any medical equipment suggested by the hospice team.
If I choose hospice, does that mean I am “giving up”?
Absolutely not. Choosing hospice care enables a person to regain a sense of control in their life and ensures relief from many distressing physical, emotional and spiritual concerns. The hospice team will support you and your caregivers in living each day to its fullest while remaining pain free. Hospice of Franklin County affirms life and believes hope and meaning can be found when quality of life becomes the focus of care.
Posted: Mon, Aug 15, 2011 09:52 PM
Updated Sun, Mar 18, 2012 12:00 AM