Hospice is a team of specially trained professionals who act as a bridge to care and resources on a person’s end-of-life journey. Research shows that individuals who choose hospice actually live longer than those who don’t. Hospice care is offered under the direction of a physician and can be provided in the home, in assisted living or nursing home settings, or in an inpatient facility. Choosing hospice is choosing hope.
- Hospice provides care and comfort when curative treatment is no longer an option.
- Through ever-advancing medical technology, pain and symptom control enables the patient to spend the remainder of the life as comfortably as possible.
- Hospice care provides clinical and professional supplies, equipment, and medications to alleviate symptoms associated with a terminal condition.
- Professional teams and volunteers help address the patient’s (and their family) medical, social, emotional,and spiritual needs.
- Hospice will help patients and their family members make decisions about how and where he/she wants to spend the rest of their life.
- Hospice coordinates with the patient’s primary care physician regarding medications, equipment, and supplies to assist with the patient’s care.
Why choose Patriot Hospice?
Patriot utilizes an interdisciplinary approach to develop a patient’s individual plan to address identified problems, needs, and goals. These plans are reviewed and updated based on the patient’s changing needs. Patients, their families, and advocates are encouraged to participate in the development of these care plans.
- Our staff members are available 24 hours a day,7 days a week for urgent and emergency issues.
- Patriot assembles highly specialized teams of care professionals based on the need of each patient. These Interdisciplinary Groups (IDG) are experts in end of life issues.
- End of life scenarios often strain family dynamics, but our experienced chaplains and social workers are equipped to address various emotional, social, and spiritual concerns in this time of need.
- We consider the entire family-not just the patient-as critical components of the decision making process. Our role is to assist the patient and families with experienced insight and guidance as we journey through end of life decisions and their outcome. We strive to enable the patient to retain as much control over these choices as possible.
- Bereavement counseling is provided to the family for up to one year after the patient’s passing.
- We focus on the holistic quality of our patient’s life rather than their longevity.
Hospice and Home Health, is there a difference?
For many, a recommendation to home health by a physician is met with relief and gratitude. On the other hand, a recommendation to hospice sometimes causes tears and resistance.
Understanding the similarities and differences may help those referred to hospice see it as a positive, helpful offer of assistance to make their journey more comfortable and less stressful.
The most important differences are:
- Intensity of services: hospice services increase in intensity over time while home health services decrease in intensity.
- Length of time services can be provided: hospice services can remain in the home much longer.
- Focus of care: Home health focuses on rehabilitation and cure, while hospice focuses on aggressive symptom management and pain control. This DOES NOT mean hospice is giving up hope. It means that they are helping you take control of your situation and ensuring that you are cared for exactly as you wish to be.
- Eligibility to receive services: Hospice requires a diagnosis by a physician of a terminal illness. See more details under the hospice category.A Comparison of Hospice Benefits and Home Health Benefits
(Allowable benefits may differ depending on Medicare or private insurance. Check with your private insurance carrier to clarify services covered under your policy).
Services Hospice Home Health Nursing facility stays Allowed: does not pay for room and board Not provided Nursing medical management and home visits Provided: visits as needed including after hours Allowed sometimes: only if patient is homebound and has teachable caregiver in home after hour on-call nurse not required Occupational Therapy Allowed: only a few visits; must be ordered by physician Covered: in the home; must be ordered by physician Oxygen Covered: if related to hospice diagnosis; must be ordered by physician Covered: with co-pay and deductibles applying; must be ordered by physician Physical Therapy Allowed: only a few visits; must be ordered by physician Covered: in the home; must be ordered by physician Physician Services Covered: Medical Director visits Covered: under regular health insurance Psychosocial services- Social Worker Covered: for patient and caregiver Covered: for patient only Respite care Covered: 5 days/ 4 nights. Not covered Around the clock care Covered: only in specific circumstances for short period “continuous care; must be ordered by physician Not covered Speech-language pathology services Covered: only a few visits; must be ordered by physician Covered: in the home; must be ordered by a physician Spiritual Care Covered Not available Transfusions Not covered: generally not covered and not allowed. Each hospice decides on a case-by-case basis. Allowed but not covered under home health benefit. Covered by other health insurance. Visits to the ER Covered: if approved in advance by hospice and related to hospice diagnosis Covered by other health insurance Visits to a Specialist Covered: if approved in advance by hospice and related to hospice diagnosis Covered by other health insurance. Visits to your physician Covered: if approved in advance by hospice and related to your hospice diagnosis Covered by other health insurance Volunteers Provided if available; no “hands-on care” Not available
Hospice vs. Palliative Care
Compared to hospice care, palliative care is a broader category of care for individuals. Palliative care physicians act as a bridge between primary care physicians and specialists to a team of individuals who can assist individuals with debilitating illnesses. These doctors can help patients and families to make decisions regarding the direction and options for treatments once a diagnosis has been made. The major difference between palliative care and hospice care is that for palliative care services, you do not have to have a diagnosis of a terminal illness.
|Question||Palliative Care||Hospice Care|
|Who can receive this care?||Anyone with a serious illness regardless of life expectancy can receive palliative care||Someone with an illness with a life expectancy measured in months not years|
|Can I continue to receive treatments to cure my illness?||You may receive palliative care and curative care at the same time||Treatments and medicines aimed at relieving symptoms are provided by hospice|
|Does Medicare pay?||Some treatments and medications may be covered||Medicare pays all charges related to hospice|
|Does Medicaid pay?||Some treatments and medications may be covered.||In most states Medicaid pays all charges related to hospice|
|Does private insurance pay?||Some treatments and medications may be covered.||Most insurance plans have a hospice benefit|
|Is this a package deal?||No. There is no ‘palliative care’ package. The services are flexible and based on the patient’s needs.||Medicare and Medicaid hospice benefits are package deals|
|How long can I receive care?||This will depend upon your care needs and the coverage you have through Medicare Medicaid or private insurance||As long as you meet the hospice’s criteria of an illness with a life expectancy of months not years|
|What organization provides these services?||Hospitals Hospices Nursing Facilities Healthcare Clinics||Hospice organizations Hospice programs based out of a hospital Other healthcare organizations|
|Where are services provided?||Home Assisted living facility Nursing facility Hospital||Usually wherever the patient resides in their home assisted living facility nursing facility or hospital. Some hospices have facilities where people can live (like a hospice residence) or receive care for short-term reasons such as acute pain or symptom management.|
|Who provides these services?||It varies. However usually there is a team including doctors nurses social workers and chaplains similar to the hospice team.||A team – doctor nurse social worker chaplain volunteer home health aide and others.|
What are the criteria to receive hospice?
Families often wait too long to receive hospice because they think you have to be dying; or they could benefit for the services but do not meet eligibility criteria.
- Your physician and the Medical Director of the hospice agency agree that you have a terminal illness and have 6 months or less to live * (more on this later).
- You and the person who makes medical decisions for you agree that you are choosing hospice instead of curative treatments such as chemo therapy, transfusion, or radiation. This is a very tricky area, and some chemotherapy is permissible while on hospice. Discuss your treatment with the hospice team or your physicians. Stopping treatments does not mean giving up hope or stopping care. Hospice care shifts from cure to aggressive comfort measures.
* No one can predict how long we are going to live. There is no crystal ball with an answer to that question. What we do know is that certain illnesses follow predictable trajectories, and physicians can guesstimate life expectancy. However, we also know that hospice, along with loving care, and emotional and spiritual well-being can prolong life. A hospice will not discharge you after 6 months unless your condition has improved to the point that you no longer qualify for their care. This is just a guideline.
What is covered under hospice?
The biggest misconception:
Hospice staff will be there all day or even 24 hours a day. If you or your loved one needs around the clock care, the hospice Social Worker will help you find individuals you can hire or a facility that can provide the care needed. HOSPICE DOES NOT COVER AROUND THE CLOCK CARE OR ROOM AND BOARD IN A NURSING HOME.
What is covered under the Hospice Benefit?
|Respite care- 5 days/ 4 nights (not in home usually at a nursing home that has 24 hour nurses on staff)||Covered||Check policy|
|Around the Clock Care||ONLY in specific circumstances for short period (called “continuous Care”) must be ordered by a physician||Check policy|
|Speech- language Pathology||Covered: only a few visits and must be ordered by physician||Check policy|
|Transfusions||Generally not covered and not allowed. Each hospice decides on a case-by-case basis. Considered curative treatment.||Generally not covered and not allowed. Each hospice and insurance carrier decides on a case-by-case basis. Considered curative treatment.|
|Visits to the ER||COVERED: IF APPROVED IN ADVANCE BY HOSPICE AND RELATED TO HOSPICE DIAGNOSIS||COVERED: IF APPROVED IN ADVANCE BY HOSPICE AND RELATED TO HOSPICE DIAGNOSIS|
|Visits to a Specialist||COVERED: IF APPROVED IN ADVANCE BY HOSPICE AND RELATED TO HOSPICE DIAGNOSIS||Check policy|
|Visits to your physician||COVERED: IF APPROVED IN ADVANCE BY HOSPICE AND RELATED TO HOSPICE DIAGNOSIS||Check policy|
|Intravenous (IV) Therapy||Not covered for hospice diagnosis||Not covered|
|Medical Equipment||Only if related to hospice diagnosis||Check policy|
|Medical Supplies||Only if related to hospice diagnosis; Wipes not included||Only if related to hospice diagnosis|
|Medical Transport – ambulance||Requires prior approval by hospice and must be related to hospice diagnosis||Check policy|
|Medications for symptom management and pain relief||Covered: only if related to hospice diagnosis||Covered: using prescription plan program.|
|Nursing Facility Stays||Covered: does not pay for room and board portion of nursing home care||Covered: does not pay for room and board portion of nursing home care|
|Nursing medical management and home visits||Covered: on-call Registered Nurse (RN) available 24/7||On-call RN available 24/7|
|Occupational Therapy||Covered- visits limited; must be ordered by physician||Check policy|
|Oxygen||Covered: must be related to hospice diagnosis and ordered by physician||Covered: must be related to hospice diagnosis and ordered by physician|
|Physical Therapy||Covered: visits limited and must be ordered by physician.||Check policy|
|Physician services||Covered: Medical Director may make home visits.||Covered: Medical Director may make home visits.|
|Psychosocial Services- Social Worker||Covered||Covered|