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Does Hospice Mean the End?

Posted by Debby Franklin on Mar 29, 2017 2:13:57 PM

Caregiver reading to a client Terry dollarphoto.jpgA person placed under hospice care may very well live beyond the 6 month time frame. Sometimes, hospice care benefits the patient so much that they are able to extend their lives and leave the hospice program.  Hospice care is a specialized service designed to provide support to the person that is ill and their loved ones during an advance illness.  Hospice focuses on comfort and quality of life rather than a cure.  The goal is to enable an alert, pain free life.  

Many people hear the word Hospice and immediately reject the idea of learning more about the benefits offered through this program.  Hopefully, this brief outline will assist in summarizing key points associated with hospice services.....

  • Hospice is appropriate when a person has a non reversal terminal illness with a life-expectancy of six month or less.  However it can also be considered when individuals have a life threatening illness or when a cure is no longer possible and treatment has slowed or stopped.  Receiving hospice does not mean giving up hope or that death is imminent.  The earlier an individual receives care, the more opportunity there is to stabilize the medical condition and address other needs.
  • The decision is not "set in stone".  A person placed on hospice is free to change their mind, leave hospice and restart standard medical care at any time.  The Medicare benefit, and most private insurance, pays for hospice as long as the necessary criteria has been achieved.  People can come on and off hospice and re-enroll as needed.  Hospice can be restarted with physician's certification at a future time.
  • In order to qualify for hospice care at home, there must be a willing, able and available caregiver in the home.  Hospice provides some care assistance such as bathing and dressing, however, it does NOT provide full time caregivers.  Many families select professional caregivers from Home Care agencies to provide "around the clock" coverage for their loved ones.
  • Coverage for hospice is available through Medicare in 44 states and the District of Columbia under Medicaid, however most private insurance plans, HMOs, and other managed care organizations include hospice as a benefit.  Through community contributions, memorial donations, and foundation gifts, many hospices are able to provide patients who lack sufficient payment with free services or charges in accordance with the ability to pay.
  • Medicare Part A beneficiaries may elect to receive hospice care for 2 90day periods, followed by an unlimited number of 60 day periods.  A physician must re certify at the start of each new period.
  • If dissatisfied, you can leave one hospice program and enter a new one once each benefit period.  All licensed hospice programs must provide certain services, but the range of support and programs may differ.  In addition, programs and operating styles may vary from state to state depending on laws and regulations and business model.
  • Hospice can take place in a Medicare approved hospice facility or in the majority of cases, at home (including assisted living or nursing facilities).  If an in-facility option is selected, the family needs to understand that charges for normal "room & board" will be the responsibility of the individual.  Investigate out of pocket expense before making the selection between staying at home vs. going to a center.
  • When hospice is received at home, a family member will remain as the primary caregiver and can be assisted by professional caregivers sent by Home Care agencies.
  • The hospice team will typically consist of a physician, nurse, social worker, counselor, physical/occupational/speech therapists, nursing assistants, and volunteers.  
  • Hospice includes a number of paid for services such as; physician and nursing assistance, medical equipment (hospital bed, wheelchair, walker, bedside commode, lift, etc), medications for symptom control and pain (a small copay may apply), dietary counseling, grief counseling, massage therapy, short term in-patient care if needed for pain and symptom management and short term respite care.
  • The respite benefit is an important one for family members.  It provides for 5 days care for the patient in a Medicare approved facility to allow the family caregiver to rest and "recharge".
  • Once hospice has been selected, the following costs will NO LONGER be covered under Medicare: treatments intended to cure the terminal illness, drugs intended to cure the illness, care from any provider that wasn't established by the hospice team and care in an emergency room/ambulance/inpatient facility unless arranged by the hospice team. 
  • According to the Medicare program, services may be provided to terminally ill beneficiaries with a life expectancy of six months or less.  If the patient lives beyond the initial six months, they can continue receiving hospice care as long as the attending physician re certifies that the patient is terminally ill.  Most paid assistance will continue to cover services as long as the patient meet the hospice criteria and is re certified.

Seeking hospice and palliative care isn't about giving up hope.  Its really about finding the appropriate level of care in one's final weeks or months.  For most the comfort of home and spending time with loved ones is desired over the cold, sterile setting of a hospital room.  

If you have made the decision to transition to hospice care and need information regarding supplemental In-Home Care assistance, we can help.  Easy Living Services, has supported Atlanta families in their efforts to keep loved ones fulfilled and safe at home since 1994.  Call us for a complimentary consultation to learn more about the benefits of Home Care Assistance, 770-442-8664.

Atlanta Caregivers

Topics: Hospice