Top 10 FAQs about Hospice and Palliative Care…
Is hospice a place one goes to right before they die?
No. Hospice is a philosophy of care, not a place, that focuses on managing one’s physical, emotional, psychological, and spiritual symptoms wherever they are living – whether in a group home, nursing facility, or their private home.
What are those ‘hospice places’ then?
These are inpatient units, or IPUs. Inpatient units are always temporary stays for patients. They are an effective way to keep hospice patients out of the hospital by helping to manage symptoms (i.e., pain, nausea/vomiting, behavior/agitation) not able to be managed at home with 24/7 nursing available. An average stay at an IPU is about 3-5 days with patients being evaluated daily on their need to stay. Some people do pass away at IPUs. Most hospice patients never need to go to an IPU. Not all hospices have IPUs but they often contract with IPUs for their patients to utilize if needed.
How many hospices are there/do I have to use the one my doctor/hospital recommends?
There are many different hospice companies in the state of Arizona alone. You as the patient have the right to choose which hospice company you want to provide care to you or your loved one. Most people needing hospice support have Medicare Part A coverage which means you can choose any Medicare certified hospice company. Unfortunately, when in a hospital or doctor’s office setting, many people feel they have to use the one recommended to them. This is not the case.
Is there a situation where I couldn’t choose my own hospice?
People who don’t have Medicare Part A coverage or don’t have Medicare benefits at all may be more limited as to which company they could choose. If one has an insurance policy with limited hospice benefits, oftentimes that insurance company will have a small list of hospice companies they consider as providers for that policy. It is ALWAYS wise to verify what insurance coverage you have for hospice BEFORE you may need to use it!
Aren’t all hospice companies the same?
All Medicare certified hospices are reimbursed the same for basic services/supplies to be provided to their patients by Medicare. However, not all hospice companies share the same philosophy of care. This may be evident in the following ways: the quality of supplies, amount of supplies, attentiveness to patients, availability of triage, spiritual and bereavement support offered to patients and families, methods of pain and symptom control, whether they treat infections, management of meds, etc.
Who qualifies for hospice?
Per Medicare guidelines/criteria, people qualify for hospice when a doctor determines they are facing a life limiting illness or condition that will most likely continue to cause decline and their patient will probably pass away in about 6 months time. A doctor gives a prescription for hospice evaluation, or hospice order, and the hospice will obtain signed consent paperwork with the patient and/or family. Then a hospice nurse evaluates to make sure the person meets Medicare criteria for hospice and care begins immediately.
Are you ‘stuck’ on hospice and no one ever comes off?
No. Per Medicare, a person will continue to receive hospice support as long as one meets the Medicare criteria pertaining to their illness/condition(s). That is the responsibility of the hospice to determine at the end of each benefit period (For Medicare, 90 days, 90 days, then continuous 60 day periods). Some people for various reasons choose to revoke hospice or hospices may discharge a patient off hospice services if they have stabilized and no longer meet criteria for that benefit.
What if I decide I don’t like my hospice company?
You have the right to transfer your care to another hospice company at any time you are not satisfied once per benefit period. To do that, you choose another hospice company, sign consents paperwork and a transfer form with them, and that new hospice company contacts the old hospice to arrange transfer of your care.
What is included in my Medicare hospice benefit?
Included in your Medicare Part A Hospice Benefit, you are assigned a hospice team that includes a RN case manager, CNA (certified nurse assistant), Social Worker and Chaplain. That team will regularly visit and address your care needs – the amount of visits will change depending on the care needed from week to week. Also, Medicare covers any DME needed (i.e., including but not limited to wheelchair, hospital bed, oxygen, shower chair, bed alarm, walker, etc.) As for supplies, this can vary in quality and amount so it is always important to ask hospices directly. Also, medications directly related to your hospice diagnosis begin to be delivered directly to you wherever home is. And 24/7 triage is offered by most hospice companies.
What is palliative care?
Whenever you see the word palliative, you can substitute the word comfort. Palliative care is ALWAYS part of hospice care, but sometimes different companies and/or doctors have unique palliative care (without hospice) options that offer help but offer much less support than hospice care.
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