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Hospice FAQ

Frequently Asked Questions About HospiceIt is important to note that hospice does not hasten death, but instead helps the individual live fully and comfortably, affirming their uniqueness and providing support to their loved ones. Here is a list of commonly asked questions.

Can someone help me know when the time is right?

Absolutely!  You do not have to have a doctor’s order to have an evaluation done.  We send out an admissions specialist that will help you know if it is the right time or not.  If your loved one meets hospice eligibility we will contact the doctor for an order for your loved one to receive Hospice care.  If it is just not time we will refer or obtain additional services that will help you if needed.

Do you really take away everything?

NO!  Hospice care many years ago took all medications away.  We do not take medications away.  We cover or pay for those medications directly related to the illness that they would be admitted to hospice for; that does not mean you can’t take the other medications, it simply means you (your insurance) will have to pay for them.

Hospice should never “tell” you what to do but instead give you guidance or recommendations.  We want you to have the right to choose how and when.  For example if you want to eat a regular diet but the recommendations is for a pureed diet….while we may know it is not the best for you…..it is still your right and choice—we are here to support you not “tell” you what to do.

Does my loved one have to be a “DNR”?

No they do not.  However we strongly recommend that you be open and honest with your loved one about resuscitation.  We will discuss allowing a natural death from admission.  Remember that our goal is to honor your loved ones wishes for comfort.

When is the right time to start the Hospice Conversation?

Hospice services can make more of a difference to patient and family comfort and quality of life when the hospice is given more time to care for the patient and family.  Many people whose family members received hospice care only for a few days before they died say that they wished that they had started hospice care earlier.

Here are some signs that it is time to consider hospice:
 
  • Treatments are no longer working or are causing more pain and discomfort than they seem to be worth.
  • The doctor says your life expectancy is 6 months or less.
  •  The patient wants to focus on the quality of their life rather than curing or receiving treatments for a non-curable disease/illness.
  • The patient has serious pain or other symptoms that are proving very difficult to manage, such as progressive weight loss, severe fatigue, difficulty with personal cares (dressing, bathing, and toileting), difficulty breathing or swallowing, sleeping more than being awake, not wanting to eat, and continuing fluid build-up in the body.
  • Family members are beginning to feel overwhelmed emotionally or physically by providing daily care for the loved one and unsure whether they are providing the best possible care; they would benefit from support and guidance from trained professionals.

How do I/we pay for Hospice Care?

All hospices (non-profit and for profit) are paid the same. Hospice Care is a medicare beneficiary covered benefit. Medicare pays 100% of hospice services. If you do not have medicare we work with all insurances and you may have a small deductible. If you have no insurance or payor sources, that’s ok too. Remember our goal is to provide care, comfort and compassion regardless of ability to pay.

How do I tell my loved one that we need to consider Hospice?

Because we know that the word Hospice frightens most people we feel that the best thing you can do is to call us and let us do the talking for you.  Our team of experts can evaluate and determine if hospice is appropriate.  We also use language that is not threatening such as “transitional care” or “palliative care”.

How often will someone from Hospice come?

Each person is different so the RN Case Manager will develop a plan of care to meet your loved ones needs.  However, our RN Case Manager will see your loved one at a minimum of 2 times a week.

How would you feel if someone said “it might be time to consider Hospice care”? 

Most feel anxiety, fear, shock or maybe even deny the comment or suggestion.  Hospice is not the end it is a level of care that provides those we love with extra help to get through a critical moment in their lives.  The criteria for hospice includes (but is definitely not limited to)
 
  • When a curative treatment (such as chemo or radiation therapy) is no longer effective, beneficial or causing worse symptoms (nausea, weight loss, fatigue)
  • Weight loss without a purpose (>10% over 3-6 months)
  • Increased hospitalizations/doctor visits/emergency room visits
  • When you decide that you no longer want to seek aggressive treatments
  • Worsening symptoms in chronic disease (edema, shortness of breath, frequent urinary tract infections/respiratory infections that do not respond to antibiotics)
  • Mobility changes (was walking—now wheelchair dependent or bed bound)
  • Talks frequently about “giving up” or “I am ready”
  • The doctor says that there is 6 months left

How do I know what a "terminal" condition is?

A terminal illness or condition is a disease that could possibly result in the death of the patient regardless of any treatment interventions" (www.merriam-webster.com ).

More often than not many people think that a terminal condition is "cancer" or that the person's life will end tomorrow.  The best determinate to knowing if a condition is terminal is to ask your physician or consider if it is life limiting.  The following are SOME examples of qualifying conditions for which hospice is beneficial
 
  • Cardiac Disease  including Heart Failure (CHF)
  • Chronic Lung Disease including COPD or Respiratory Failure
  • Kidney Disease such as Chronic Renal Failure
  • Stroke/TIA's
  • Coma
  • AIDS/HIV
  • Cancer
  • Neurological Conditions such as Parkinson's and ALS
Hospice can also be helpful for other conditions that are serious, terminal or causing a disruption in your quality of life.

What does 6 months or less really mean?

When a doctor says “you have 6 months or less” this simply means that without any intervention your life could possibly be limited to 6 months.  This DOES NOT mean that it necessarily will or that you have to give up.  Hospice care is an intervention that can help give your loved one better quality of life.

What is so special about Hospice care?

Hospice care is driven on the philosophy of quality of life through compassionate interventions.  Meaning we look at how to make you have the best of your life right now.  We provide interventions that help you manage pain, discomfort, anxiety and fear.  We don’t always use medications—we do have massage, essential oils, animal visits…..we look out of the box to meeting you and your family’s needs.  We also do early interventions for your family to help them prepare for if and when that “time” comes.  We want them to be comfortable and have an understanding of what is happening.

Who is the Hospice Care Team?


The Hospice care team is a group of specially trained staff that have an understanding of several diseases and how to manage multiple complications from these diseases.  The team works together with you and your loved one to reach the best outcomes.  The interdisciplinary team may include but is not limited to:  Your Primary Care Physician, the Hospice Physician, the RN Case Manager, the Home Health Aide, the Social Worker, the Spiritual Advisor, the Bereavement Coordinator, and the Volunteer Coordinator.  This team works effortlessly to help ensure that your loved one is provided with high quality care.

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