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Common Questions in regards to Hospice Care.
When should hospice care be considered?
At anytime when there’s a decline in health and a life limiting illness, patient and family should discuss all of patient’s care plan options. Patient and family should be involved and informed of their choices of care including if hospice care is appropriate. Hospice care is a form of treatment and should not be considered as giving up. We are always available to assist you in discussing your options and helping with your advance care planning.
What is hospice care?
Hospice Care is a compassionate and a higher level of home care that is designed to provide non-curative treatment and comfort for those who are facing a life-limiting illness. It offers a support system of medical, social, psychological, and spiritual services that promotes dignity and affirms quality of life. This comprehensive and specialized care allows the patient, family, and other loved ones to make choices about what is important to them.
How does hospice care work?
In most cases, a family member serves as the primary caregiver and helps make decisions for a loved one. The caregiver works with the professional, experienced members of the hospice care team to develop a plan to provide treatment, support, personal care and a number of specialized services for both the patient and family. At AMHA, our hospice care team is available 24 hours a day, 7 days a week, to provide assistance in managing your individual needs.
The Hospice Care Team includes:
- Patient and Family
- Attending Physician
- Hospice Care Physician
- Hospice Care Nurses
- Home Health Aides
- Social Workers
- Physical, Speech, and Occupational Therapists
- Spiritual Counselors
- Bereavement Counselors
Who is eligible for hospice care?
The hospice care benefit is intended primarily for any individual with a life limiting illness whose life expectancy is six months or less, should the illness run its usual course. However, the Medicare program recognizes that not all terminal illnesses have a predictable course; therefore, the benefit is available for extended periods of time beyond six months.
How can I arrange for hospice care services?
Anyone can make a referral for hospice care services. You should feel free to talk with your doctor, your minister, or a trusted friend when making this decision. You also may choose to contact us to learn more about our services and to arrange for a meeting in your home to discuss the program. We are also available to meet with you and provide care in local hospitals, or in extended-stay facilities, such as nursing homes and assisted living centers.
What if my physician doesn’t know about hospice care?
Most physicians are familiar with hospice care. However, if your physician would like to receive more information about our services, we would be glad to reach out and provide this educational outreach as part of our mission. Hospice care information also is available from the National Hospice Palliative Care Organization, the Centers for Medicare and Medicaid Services Hospice Center, Veteran Administration, and many other health organizations.
Can I keep my personal physician if I choose hospice care?
Yes. You may keep your personal physician while you are under hospice care. Hospice care reinforces the primary physician/patient relationship and considers this bond to be a high priority.
What does the hospice care admission process involve?
Once you have made a decision to select hospice care, an AMHA representative will contact you to discuss the program and to determine your eligibility. Your physician will then be contacted to discuss your decision. Finally, you will be asked to sign consents forms that are similar to the ones that you would sign before receiving any other special medical treatments or services.
What are the different levels of hospice care?
Hospice care recognizes that different patients require different levels of care, and we respond by offering the category of care that meets the individual patient’s needs – in the location that is most appropriate and comfortable. These categories of hospice care include:
Routine Home Care
Routine care is the most common level of hospice care. Care is provided at the patient’s residence, which can include private residence, assisted living, or a nursing facility.
If pain or symptoms cannot be controlled at home, the patient might be taken to a hospice inpatient facility or nursing facility that has a registered nursing available 24 hours a day to provide direct patient care. Once symptoms are under control, hospice coordinates with care team so that the patient can return home.
Many patients have their own caregivers, often family members. Respite are is provided to provide temporary relief to the patient’s primary caregiver. Respite care can be provided in hospice facility or long term care facility that has a sufficient 24 hour nursing personnel present on all shifts to guarantee that patient’s needs are met. Respite care is provided for a maximum of 5 consecutive days.
Continuous care is provided for between 8 and 24 hours a day to manage pain and other acute medical symptoms. Care must be predominately nursing care, supplemented with other hospice services and is intended to maintain the patient at home. When the crisis is over, the patient can return to routine care in the home.
Can a hospice care patient who shows signs of recovery be returned to regular medical treatment?
Yes. If a patient’s condition improves, and the disease goes into remission, the patient can be discharged from hospice care and returned to regular medical treatment. Likewise, should the patient ever need to return to hospice care in the future, these services could be resumed at the patient’s request. In fact, many of our patients do get better under our care, and we firmly believe that no patient should ever have to choose between the hospice care benefit and hope for recovery.
Must someone be with the patient “at all times”?
No. It is not necessary for someone to be with the patient all the time. However, it is recommended that someone be with the patient as often as possible in the later stages of care.
How difficult is caring for a dying loved one at home?
The dying process can be very emotional and scary, especially when you’re caring for someone you love. Our job is to make it easier and make sure you have the information, education, training and support to get through these hard times. Nights can be especially difficult and they may sometimes seem very long. However, our Hospice Care team is available 24 hours a day, seven days a week, when you need us. You’ll never be alone.
What do Hospice Volunteers do?
Hospice Volunteers are a special group of people that give of their time and talents to help address the greatest needs of our patients and their families. They are available to visit with you and provide support. They may read, write letters, or reminisce with you and your loved ones about life’s many experiences. Their support both enhances the quality of life for patients and helps to relieve some of the demands that are often placed on caregivers.
Can I be cared for by hospice care if I live in a nursing home or another type of long-term care facility?
Yes. All Hospice Care can be provided in a nursing home, if the facility has a written agreement to provide these services to their residents. In addition to the standard services provided by the nursing home or another care facility, residents will receive specialized visits from our Hospice Care team, including nurses, home health aides, chaplains, social workers and volunteers.
How does hospice care “manage pain”?
Our hospice care nurses and doctors have vast experience in pain management for our patients. They are up to date on the use of the most effective medications and devices to treat all forms of pain and to relieve symptoms. At AMHA, we believe that emotional and spiritual pain is just as real as physical pain so our hospice team will develop a plan of care to address each patient’s individual needs. Our hospice care specialists work as an integrated team with the patient and family in managing pain and symptoms in a way that brings more life and greater quality to each and every day.
What is hospice care’s success rate in managing pain?
Our hospice care team members are specialists in managing pain and symptoms related to life-limiting illnesses. Using a combination of medications, counseling, and therapies, most people can attain a level of comfort that is acceptable to them.
Will medications prevent me or my loved one from being able to talk or from knowing what’s happening?
Usually not. The goal of hospice care is to help individuals live as actively as possible, free of pain or discomfort.
Do Medicare, Medicaid, VA, and other insurance programs cover hospice care?
Hospice care is widely available and covered by Medicare Part A. It is also covered by Medicaid in most states, as well as by many other private or managed care insurance providers, usually with no out-of-pocket costs, deductibles, or co-pays. Services covered by Medicare include:
- Medications for symptom management and pain relief
- Medical equipment and supplies
- Physician services
- Nursing care
- Home health aide
- Social worker services
- Physical, occupational and speech therapy
- Nutritional, spiritual and grief counseling
- Short-term general inpatient care and respite care
If a patient is not covered by Medicare or any other health insurance, will hospice still provide care?
Yes. The first thing hospice care will do is assist you in finding out whether you are eligible for any coverage. If not, most hospices will provide care for anyone who cannot pay by using money raised from the community or from memorial funds.
What hospice services does AMHA provide?
Provided wherever a patient calls home, AMHA Hospice is available 24 hours a day, 365 days a year, at no cost to eligible patients with Medicare, Medicaid, VA, or most commercial insurance through most providers. These services include:
- All medicines, medical equipment and supplies related to the hospice care diagnosis
- Medication management to control pain and symptoms
- Physician services to manage medications
- Nursing and home health aide visits to provide direct care
- Support through social work, counseling and chaplain services
- Volunteer services to provide companionship
- Bereavement services for a minimum of 13 months after a loss
Is there any special equipment or are there changes that I have to make in my home before hospice care begins?
No. We will help you determine what you need and assist you in obtaining any special equipment or making any changes to your home.
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 our Hospice Care team will do is to prepare a plan that will help you determine the amount of care that is needed. In addition, our hospice team will make regular visits to your home, and we are always available to answer your questions, to provide support, and to teach caregivers. Some of our patients don’t have a primary caregiver living with them, and we can make arrangements and develop a care plan for these situations.
Does hospice care provide any help to the family after a patient dies?
Yes. AMHA Hospice provides continuing contact and support for caregivers and families for up to 13 months following the death of a loved one. Also, we sponsor bereavement groups, hold memorial services, and provide support for anyone in the community who has experienced the death of a family member, friend or loved one.