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What To Know About Hospice Care

doctor hands hold male hand in hospital

End-of-life is one of the most vulnerable times for patients and their loved ones. The entire situation—including the decisions and emotions—can be overwhelming. Thankfully, there is a healthcare service dedicated to helping people in these very moments of crisis: hospice care.

What is hospice care?

Hospice care is specialty medical care for people who have been determined by a medical professional to be in the last six months of life. Hospice happens when a cure isn’t possible or an individual no longer wants certain treatments. An interdisciplinary team of doctors, nurses, social workers, and others treat the physical, emotional, and physical needs of the individual; they also support loved ones and caregivers.

What is included in hospice care?

There are a wide variety of services to manage symptoms, pain, and needs in hospice; hospice workers are available 24 hours a day, seven days a week to respond to issues or concerns throughout the care period. Other services may include:

  • An initial doctor’s visit, on-going nursing care, and prescription drugs;
  • Physical, occupational, and speech therapies as recommended;
  • Specific equipment (like hospital beds and wheelchairs) and supplies (such as bandages and catheters);
  • Regular in-home visits by hospice and home aides, as well as check-ins with social workers;
  • Respite care to provide a break for unpaid caregivers.

Importantly, hospice also provides grief and loss counseling for the patient and their loved ones and bereavement support for survivors after death.

When should hospice start?

To get the most benefit from hospice, it should be started earlier rather than later. Here are three questions to help determine if the time is right for hospice:

  1. Does the person have a life-limiting illness? Remember, hospice is designed for the last months of life.
  2. Has the person been declining? For example, the person can no longer do routine activities to care for themselves or the person has had multiple hospital visits in a short time.
  3. What does the person want? Some may want more time and continue to seek a cure; hospice cannot occur in conjunction with treatment. Others may want to focus on the quality of life, making them a good fit for hospice care.

Where does hospice care happen?

Because hospice care is an approach to medical care, it can take place wherever the individual lives—whether a private residence, a shared facility, or somewhere else. The purpose is to ensure that the patient is surrounded by important items, memories, family, and friends that bring comfort.

Who pays for hospice care?

Most hospice patients are eligible for Medicare to pay for care and services. There are no deductibles on this care, although small copays may be required for prescriptions and/or respite care. In many states, Medicaid offers similar coverage. For those active in military service, Tricare subsidizes hospice care that occurs in the United States, District of Columbia, and U.S. territories. Health insurance and private pay are accepted, and some providers have an option for charity care for those who qualify. Hospice providers usually have someone on staff who can explain in detail about potential costs, established coverage, and likely out-of-pocket expenses.

Hospice care can be a gift to individuals and their loved ones at a difficult time. As Atul Gawande explained in his book Being Mortal, “Our ultimate goal, after all, is not a good death but a good life to the very end.”

Source: IlluminAge AgeWise with information from the Hospice Foundation, Medicare.gov, and the National Institute on Aging.

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