I know someone who has been diagnosed with a life ending disease; how can I get him/her help?

Anyone, whether a family member, patient, friend, physician or healthcare professional, may make a referral to Hospice Care. Referrals are confidential. Look at your congregation’s prayer list. Keep an eye out for neighbors and friends in your community diagnosed with terminal illnesses. If you hear of someone, call our referral line 1-866-656-9790 with a name, address, phone number and medical problem. HCC will then call the physician and visit the patient to give him/her information on our services.

Are hospice services only for the elderly?

No. People of all ages, including infants, may receive our care.

Can I still use my own doctors?

Yes. Your doctor becomes part of our team. We will communicate and work with them on a daily basis.

What if I want to drive and I’m not ready to be homebound?

You can. To qualify for hospice you DO NOT have to be homebound. We want you to live your life to the fullest. We encourage our patients to go out and do what they feel up to, and what brings them joy. We will even try to facilitate your activities.

Where is care provided?

In a setting that best suits the needs of the patient and caregivers. Care may be provided at home, inpatient facilities or a combination of sites.

If I am in hospice and being cared for at home, am I allowed to go to the hospital?

Yes. Every effort is made to keep a patient at home and pain-free, however, a time may arise when a patient needs urgent care. In those instances, the hospice nurse is called, the situation assessed, and if needed, transportation is arranged to go to the hospital.

Why would hospice appeal to a loved one or me?

Hospice is special because it concentrates on care, not cure. It enables people with a terminal illness to make decisions about how and where they want to spend the rest of their lives. Hospice Care treats the whole patient.   The family is viewed as part of the unit of care. It emphasizes pain control and living life fully.

If I don’t have insurance, who pays?

Hospice Care bills patients based on a sliding scale. Patients will never be refused treatment for an inability to pay.

Will I lose my house?

No. Hospice receives reimbursements and funding from Medicare, Medicaid, and private insurance, and covers other expenses.

When is the right time to ask about 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.

How does hospice care begin?

Typically, hospice care starts as soon as a formal request or a ‘referral’ is made.  Anyone can make a referral; however, it is usually made by the patient’s primary physician who will certify the patient’s prognosis.  A Hospice Care Nurse will make an effort to visit to assess the patient within hours or the same day of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver.  Usually, care is ready to begin with the call. However, in urgent situations, hospice services may begin sooner if physician certifies and patient records and orders are obtained.

Will I be the only hospice patient that the hospice staff serves?

Every hospice patient has access to a hospice volunteer, registered nurse, social worker, home health aide, and chaplain (also known as the interdisciplinary team).  For each patient and family, the interdisciplinary team writes a care plan with the patient/family that is used to make sure the patient and family receive the care they need from the team.   Typically, full-time registered nurses provide care to about a dozen different families.  Social workers usually work with about twice the number of patients/families as nurses.  If needed, home health aides, who provide personal care to the patient, will visit most frequently.

All visits, however, are based on the patient and family needs as described in the care plan and the condition of the patient during the course of illness.  The frequency of volunteers and spiritual care is often dependent upon the family request and the availability of these services.  Travel requirements and other factors may cause some variation in how many patients each hospice staff serves.

When are hospice services available?

Hospice Care provides service 24 hours a day, seven days a week all year long. Nurses are available to respond to a call for help within minutes, if necessary.  We have chaplains and social workers on call as well.

How does the hospice work to keep the patient comfortable?

Many patients may have pain and other serious symptoms as illness progresses.  Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress.  Because keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice.  Hospice staff works with the patient’s physician to make sure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan.  The care plan is reviewed frequently to make sure any changes and new goals are in the plan.

What role does the hospice volunteer serve?

Hospice volunteers are generally available to provide different types of support to patients and their loved ones including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members.

Because hospice volunteers spend time in patients’ and families’ homes, each hospice program generally has some type of application and interview process to assure the person is right for this type of volunteer work.  In addition, hospice programs have an organized training program for their patient care volunteers.  Areas covered by these training programs often include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss and grief and bereavement support.

Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?

Hospice services can be provided to a terminally ill person wherever they live.  This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility.  The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.

What happens if my symptoms are out of controI and I cannot stay at home due to my increasing care need and require a different place to stay during my final phase of life?

Short term patient care is available at the Hospice Care Regional Inpatient Center for patients who cannot stay where they usually live.  These patients may require a different place to live during this phase of their life when they need extra care.  The goal is to get your situation under control and get you back home as soon as possible. Hospice services in this setting are covered under the Medicare or Medicaid Hospice benefit.

Do state and federal reviewers inspect and evaluate hospices?

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.

How can I be sure that quality hospice care is provided?

Many hospices use tools to let them see how well they are doing in relation to quality hospice standards.  In addition, most programs use family satisfaction surveys to get feedback on the performance of their programs.  To help hospice programs in making sure they give quality care and service, the National Hospice and Palliative Care Organization has developed recommended standards entitled ‘Standards of Practice for Hospice Programs’ as one way of ensuring 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 customary practices of the hospice, such as policies and procedures, medical records, personal records, evaluation studies, and in many cases also include visits to patients and families currently under care of that hospice program.  A hospice program may volunteer to obtain accreditation from one of these organizations.

Find more answers at NHPCO…

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