Frequently Asked Questions About Hospice

At any time during a life limiting illness, it is appropriate to discuss all of a patients care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping an all-out effort to beat the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.

The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.

Most physicians know about hospice. If your physician wants more information about hospice, it is available from the Academy of Hospice Physicians; medical societies; the Indiana Hospice Organization, (317) 338-4050; the National Hospice Helpline, (800) 658-8898; or Hope Hospice of Fulton County, Indiana, (574) 224-4673.

Certainly. If the patients condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.

One of the first things hospice will do is contact the patients physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Hospices have medical staff available to help patients who have no physician.) The patient will also be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.

The so-called hospice election form says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.

Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease gets worse. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

There is no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed in your situation. Hospice staff visits regularly and are always accessible to answer medical questions and provide support.

In the early weeks of care, its 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.

Its never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. So, hospices have staff available around the clock to consult with the family and make night visits if the need arises. To repeat: Hospice can also provide trained volunteers to provide respite care, to give family members a break.

Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, home health aides, clergy, therapists, and volunteers -- and each provides assistance based on his or her area of expertise. In addition, hospices help provide medications, supplies, equipment, hospital services, and additional helpers in the home, if and when needed.

Hospices do nothing either to speed up or to slow down the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, so hospice provides its presence and specialized knowledge during the dying process.

No. Although 90% of hospice patient time is spent in a personal residence, some patients live in nursing homes or hospice centers.

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, as it addresses each.

Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling.

Very high. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.

Usually not. It is the goal of hospice to allow the patient to be pain free but alert. By constantly consulting with the patient, hospices have been very successful in reaching this goal.

Hospice is not an off-shoot of any religion. While some churches and religions have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular site of beliefs.

Hospice coverage is available widely. It is provided by Medicare nationwide, by Medicaid in over 30 states, and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

Medicare covers all services and supplies for the hospice patient. In some hospices, the patient may be required to pay a 5% or $5 co-payment on medication and respite care. Hope Hospice of Fulton County does not charge a co-payment.

The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, most hospices will provide for anyone who cannot pay using money raised for the community or from memorial gifts, foundation gifts, or grants.

Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. Most hospices also sponsor bereavement groups and support for anyone in the community who experienced a death of a family member, a school friend, and the like.