MYTHS AND FACTS
MYTHS AND FACTS REGARDING HOSPICE
Hospice shortens life
Fact: The goal of hospice is to make the remaining time one has more comfortable. Hospice is not designed to either prolong or shorten someone’s life, but rather focus on quality of life. In some instances, patients even “graduate” from hospice care.
Hospice is expensive
Fact: Hospice is funded by Medicare Part A. Medicaid and also private insurance pays for the benefit. Often times, hospice services can actually remove some financial burden families or responsible parties, who may otherwise need to pay out-of-pocket for medications or equipment like beds or wheelchairs, etc.
Hospice care is provided at home
Fact: Hospice in general is a type of care. While there are many facilities that provide hospice care such as hospitals, nursing facilities, assisted living communities, and board and care homes, hospice care is provided in the home or wherever the patient resides.
Hospice care is a simple concept that can be difficult to understand. Whether you are a patient, family member or clinician, having the proper information about Hospice services can help you make the best decisions about whether hospice is appropriate for you.
Here are some facts about hospice
Hospice is for people with advanced illnesses
Hospice is for pain and symptom management for patients with serious illnesses, no matter their age, culture, beliefs, or cause of illness.
Hospice can happen anywhere
Hospice is a medical care service that comes to the patient. Patients at home feel better, surrounded by the people and things that they know and love.
Hospice is a choice
Patients can leave, or “revoke their hospice status”, at any time for any reason. Patients can also come back to hospice at any time, as long as their meet the eligibility guidelines.
Patients can keep taking some medicines while on hospice
Hospice patients get medicines that bring comfort and improve the quality of their lives.
Hospice gives medicines as needed to help with symptoms
Hospice doctors try to give the proper dosage of medicine to manage symptoms and ease pain. Adjustments can be done frequently and as needed.
There is no limit to the time a patient can be on hospice
Hospice is for patients who have 6 months or less to live according to their doctor, and it can be extended when needed. Oftentimes, we hear patients and families say “I wish we had known about hospice sooner.”
Hospice provides home medical equipment and supplies related to the cause of the illness
This includes equipment such as: shower chairs, oxygen tanks, hospital beds, toileting supplies, and more. Your hospice team will help you to understand how to operate everything.
Hospice supports the family
There is such an overload of things and information! We are here to help along the way, as well as provide emotional and spiritual support for the loved ones for more than one year after the patient passes.
Family and/or friends or private caregivers can provide care with support from the hospice team
Family, friends and sometimes private caregivers are the primary caregivers, supported and trained by an expert team that makes regular, scheduled visits. For patients who live in assisted living communities or skilled nursing facilities, the hospice team works together with the staff to provide a continuum of care.
Most hospice patients do not have any out-of-pocket expenses
Because Hospice is a Medicare Benefit, Medicare Part A covers up to 100% of the cost of hospice care related to a hospice eligible patient’s illness with no deductible or copayment. Private or employer-provided health coverage can vary. Check with your insurance provider for details about hospice eligibility, coverage, and out-of-pocket expenses. Medicaid provides hospice coverage, but it varies by state.
Timely and appropriate identification of hospice-eligible patients increases the likelihood that they and their families will benefit from compassionate, end-of-life care. By law, healthcare professionals must certify that patients meet guidelines to be eligible for a referral to a hospice provider.
Who is Eligible for Hospice Care?
For a patient to be eligible for hospice, consider the following guidelines:
☛ The illness is terminal (a prognosis of ≤ 6 months) and the patient and/or family has elected palliative care.
☛ The patient has a declining functional status as determined by either:
❖ Palliative Performance Scale (PPS) rating of ≤ 50%-60%
❖ Dependence in 3 of 6 Activities of Daily Living (ADLs)
☛ The patient has alteration in nutritional status, e.g., > 10% loss of body weight over last 4-6 months
☛ The patient has an observable and documented deterioration in overall clinical condition in the past 4-6 months, as manifested by at least one of the following:
❖ ≥ 3 hospitalizations or ED visits
❖ Decrease in tolerance to physical activity
☛Decrease in cognitive ability
☛ Other comorbid conditions
These guidelines—provided as a convenient tool and not as a replacement for a physician’s professional judgment—help physicians determine when their patients meet clinical guidelines for hospice eligibility for life-limiting illnesses.
HOSPICE OFFERS A FULL RANGE OF CARE
there are 4 types of care.
Routine Home Care
Most hospice care is provided at home, wherever the patient resides, and there is a plan of care that is followed by the medical team.
Continuous Home Care
When medically necessary, acute symptom management is provided wherever the patient lives by the hospice staff, up to 24 hrs. per day, to avoid hospitalization, and until the symptoms are under control.
If a patient’s needs cannot be managed at home, general inpatient beds in either a hospital or acute care setting are utilized. This will also provide around the clock hospital care to manage the uncontrolled symptoms until the patient is able to return home.
Limited to up to five consecutive days and nights, respite care provides a brief “break” for the patient’s primary caregiver by admitting the patient into an inpatient setting for symptom and pain management.