What is hospice?
Hospice care involves a core interdisciplinary team of professionals and volunteers who provide medical, psychological and spiritual support for the seriously ill and assistance to their families. Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the patient. Members of the hospice team make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week. Hospice care revolves around the importance of advocating the needs of the seriously ill. Hospice care neither hastens death nor prolongs life, but strives to make death a natural part of life.
How many people in the United States seek hospice care?
According to the National Hospice and Palliative Care Organization, page 4 of the NHPCO Facts and Figures, 2014 edition In 2013, an estimated 1.5 to 1.6 million patients received services from hospice. This estimate includes:
- patients who died while receiving hospice care
- patients who received care in 2012 and who continued to receive care into 2013 (known as “carryovers”)
- patients who left hospice care alive in 2013 for various reasons including extended prognosis, desire for curative treatment, and other reasons (known as “live discharges”)
What is your mission?
Our mission is to make a positive difference in the lives of our patients, their families, and our community by providing quality hospice care with compassion and experience. We embrace these guiding values as established by the National Hospice and Palliative Care Organization:
- Respect, trust, and inclusion.
- Business ethics and integrity.
- Service excellence.
- Innovation and adaptability.
- Collaboration and teamwork.
- Financial stewardship and accountability.
Who refers patients to hospice?
The contact with hospice may be initiated by a medical professional, community agent, friend, family member, or the patient. It can begin with a call to a hospice office. A hospice admission nurse will consult with the patient, family and primary care physician to assess whether hospice care is appropriate and desired upon receiving a request for services.
When should a decision about entering hospice be made? Who should make it?
The earlier you call, the more the hospice team can do to help. At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law, the decision belongs to the patient. Hospice staff members are always available to discuss this decision with the patient, family and physician.
Should I wait for our physician to raise the possibility of hospice?
The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.
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. Consent forms will be signed by the patient and/or caregiver. The hospice election form reads that the patient understands that the care is palliative (aimed at pain relief and symptom control) rather than curative. It also outlines the services available. A call to our office, at 806.356.0025 or toll free at 866.654.2941, can put you in touch with one of our admission nurses who will guide you through the process.
What is meant by Interdisciplinary Hospice Team?
The hospice team consists of the following: Physicians, registered nurses, licensed vocational nurses, social workers, home health aides, trained hospice volunteers, and providers of spiritual care and bereavement support. An individual plan of care is developed by the team and evaluated regularly to assure quality care is provided. Family members and patients are invited to schedule times to meet with the team to facilitate communication.
What does it mean when hospice talks about a primary caregiver?
A primary caregiver is someone (usually family member or close friend) who will monitor the patient’s care, administer medications, provide meals and meet the personal care needs of the patient.
Is the home the only place hospice care can be delivered?
No. Although most hospice services are delivered in a personal residence, assisted living centers and nursing facilities are “home” to many of our patients. Hospice provides care to the patient wherever they are – whether they are at home or in a facility.
What if a patient’s pain and symptoms cannot be managed in a home or facility setting?
Patients who meet the criteria for acute, hospital-like care because of their symptoms or pain may receive their care as residents of an inpatient hospice setting. The inpatient unit of BSA Hospice of the Southwest is located on the upper level of Childers Place in the medical center of Amarillo—near Bivins Nursing & Rehab and the Discovery Center.
Where do most hospice patients reside at the time of their death?
According to the National Hospice and Palliative Care Organization, page 6 of the NHPCO Facts and Figures, 2014 edition:
Patient’s Place of Residence:
- Private Residence 41.7%
- Nursing Home 17.9%
- Residential Facility 7.0%
- Hospice Inpatient Facility 26.4%
- Acute Care Hospital 7.0%
How many family members or friends does it take to care for a patient at home?
There’s no set number. One of the first things a hospice team will do is prepare an individualized care plan that will, among other things, address the amount of caregiving a patient needs. Hospice staff members visit regularly and are also always accessible by phone to answer questions and provide supportive care.
Must someone be with the patient at all times?
It is usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. Volunteer services may be available to coordinate with family members and friends to provide additional support.
What specific assistance does hospice provide home-based patients?
A team of physicians, nurses, social workers, home health aides, as well as spiritual care and bereavement specialists care for hospice patients. Each provides assistance based on his or her area of expertise. The work of these compassionate professionals is supplemented by a wonderful team of well-trained volunteers who add their touch to benefit hospice patients and their caregivers. In addition, hospice helps provide medications, supplies and equipment related to the terminal illness of the patient.
Can a hospice patient who makes significant improvement return to regular treatment?
If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice. If a discharged patient should later need to return to hospice care, Medicare and most private insurance allow additional coverage for this purpose.
Does hospice do anything to make death come sooner?
Hospice does nothing to speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides supportive presence and specialized knowledge and skills during the dying process.
How does hospice help manage the pain of a patient?
Hospice nurses and doctors are up-to-date on the latest medications and techniques to treat pain and offer symptom relief. The success rate for hospices in battling pain is very high. Most patients can attain a level of comfort that is acceptable to them and their caregivers. Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain, so it addresses these as well. Members of the spiritual care and bereavement teams are available to assist family members as well as patients.
Is it true that only cancer patients can receive hospice care?
Although approximately 38 percent of the patients admitted to hospice programs throughout the nation have conditions related to cancer, other common diagnoses include heart, lung and liver disease, AIDS, adult failure to thrive, neurological disorders such as Alzheimer’s, Lou Gehrig’s disease, and other life-limiting diseases.
Will medications prevent the patient from being able to talk or know what’s happening?
This is usually not the case. It is the goal of hospice to help patients be as comfortable and alert as they desire by continuing to consult with the patient and caregivers. Hospices have been very successful in reaching this goal.
Is hospice affiliated with any religious organization?
Hospice care is not an offshoot of any religion. A hospice team serves the broad community and accepts patients without regard to religion, race, color, national origin, disability, age, gender, creed, or sexual orientation.
Is hospice care covered by insurance?
Hospice coverage is widely available. It is a benefit provided by Medicare, Medicaid and many private health insurance policies. The hospice social worker can help a patient explore their benefit options.
If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Hospice is a free benefit of anyone who qualifies for Medicare. Therefore, Medicare covers hospice services, medications, medical equipment, and supplies for the palliation and management of the patient’s terminal illness, according to the hospice plan of care. Expenses for personal needs and care unrelated to a patient’s diagnosis may be covered by additional insurance or the resources of the patient and/or family.
How many hospices are there in the United States?
The number of hospice programs nationwide continues to increase — from the first program that opened in the country during 1974 to over 5,800 programs in 2013. This estimate includes both primary locations and satellite offices. Hospices are located in all 50 states, the District of Columbia, and US territories. (According to the National Hospice and Palliative Care Organization, page 8 of the NHPCO Facts and Figures, 2014 edition )
Does hospice provide help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least one year following the death of the patient. Bereavement support is often provided through phone contacts, printed materials, and memorial services. At BSA Hospice of the Southwest, presentations are also offered during the fall to help the bereaved better cope with holidays and special days. Throughout the year, most hospice groups sponsor grief support groups for “their families.” The grief support groups of BSA Hospice of the Southwest are available without charge to anyone in the community who has experienced the death of a family member or friend.
What do volunteers do for hospice?
Volunteers do many things! There are opportunities for them to work in the home or facility setting with patients and caregivers. Some volunteers help with administrative duties in the hospice office. Others make phone calls to our bereaved or to the caregivers of our patients. A search of hospice websites usually offers additional information about what volunteers can do and how they can get involved in the process.
Can I Keep My Physician When I Have Hospice Care?
We find that many hospice patients want their own physicians to manage their care during this important time of their lives and they are afraid that this is not possible.
Most hospices welcome physicians to stay on as the attending physician for their patients. Medicare will continue to reimburse these physicians for office visits, home visits and “care plan oversight.” As the attending physician, your physician may be notified for all orders, consulted at every change of your condition and sign the death certificate.
Many physicians understand and embrace the importance and benefit of hospice services offered to their patients; however, there are some who find that the hospice physician is the best one to care for their patients.
Most hospices provide patient updates to the referring physician and or their nurse even if they don’t stay on as the attending.
Also, most hospices have physicians who visit every patient regardless of whether their physician stays on as their attending. Each patient does have the right to have a physician who is managing their care, visit in their home or nursing home or where ever they reside.
Yes, your physician, should they choose to do so, can continue to manage your care for the rest of your life.
Furthermore, if you are 65 and older, the Hospice Medicare Benefit will cover the costs of your hospice care—you have paid for it. Death is not an option, but the way you choose to die is an option and we hope you get the opportunity to experience hospice care when you need it.
Hospices don’t want you to die, they want you to live as well as possible for the rest of your life.
Can the family reach hospice staff during the night and weekends, if necessary?
A team member from hospice can be reached at all times, 24 hours a day, 7 days a week, by simply calling 806.356.0025 or toll free 866.654.2941.