Frequently Asked Questions
- How Can Hospice Help?
What types of diseases are helped the most by hospice care?
Hospice is beneficial for anyone, of any age, with any life-limiting disease. Though many patients have cancer, Center for Hospice Care also has great expertise in providing comfort and symptom control for patients in the final stages of lung, heart and kidney disease, Alzheimer's and other types of dementias, stroke, neuromuscular diseases, AIDS and many other illnesses. Hospice care can also be beneficial for people who are in a severe state of decline due to frailty or other disorders associated with aging.
When is someone "eligible" for hospice care?
Medicare, Medicaid and most insurance plans provide coverage for hospice care when physicians predict a patient has six months, or less, to live and curative treatment is no longer being sought. Please understand that the six-month prognosis is merely a guideline. Hospice re-evaluates patients every 60 days and, as long as their conditions continue to decline, they are re-certified for hospice coverage for as long as they live.
Won’t our doctors tell us when it’s time for hospice care?
Not always. Many physicians hesitate to broach the subject of hospice because they don’t want to destroy your hope. Frequently, they will continue to pursue treatment because they assume that’s what you want. In other cases, such as congestive heart failure or COPD, it is difficult for them to predict the rate of a patient’s decline. When a doctor does mention hospice, even casually, you should discuss it immediately. In fact, he or she may actually be relieved if you bring up the subject. It is important that you understand the benefits of curative vs. comfort care, and that you and your doctor share the same goals for maintaining quality of life.
What are some signs that a person may be ready for hospice care?
- An increase in pain, nausea, breathing distress or other symptoms;
- Repeated hospitalizations or trips to the ER;
- Failure to "bounce back" after medical set-backs occur;
- Increasing assistance needed for walking, eating, bathing, dressing and/or going to the toilet;
- Decreasing alertness – patient is emotionally withdrawn, sleeping more or having increased difficulty with comprehension.
What are some signs that our family could benefit from hospice care?
- You are physically and/or emotionally exhausted from caring for your loved one;
- Your family is feeling isolated because of care-giving demands or the uncertainties you feel about your loved one’s future;
- The patient or members of your family appear to need emotional support to cope with the impending death;
- You are overwhelmed by the myriad of physical, financial, emotional and spiritual concerns arising because of the illness.
Can a patient stop having hospice care?
Yes. Patients always have the right to choose what type of care they receive. If they and their physicians decide to try another approach, we will assist them in making that transition.
- Starting the Hospice Conversation
"Mom will think we’re giving up. How can we start talking about hospice?"
When patients choose hospice care, they’re not giving up – they’re taking control. Hospice enables them to decide exactly how, where and with whom they will spend the rest of their lives. Most patients find hospice care to be a liberating experience that brings them both physical and emotional relief. Quite often they say: "I wish I’d entered the hospice program sooner."
"Dad won’t even consider hospice, but the rest of us need help. What can we do?"
Most patients don’t want their caregivers to be excessively burdened by their illness. Help them understand that the greatest gift they can give their family is the ability to spend quality time with each other. Hospice supports the entire family so everyone can be physically and emotionally available to focus on important end-of-life issues.
"We haven’t even talked to my sister about the fact that she’s dying. How can we bring up hospice?"
Center for Hospice Care has great expertise in talking with patients and their families about life-limiting illness. We can meet with patients anywhere, anytime, to discuss their health needs, learn their personal feelings and desires, and introduce the concept of hospice care. These conversations usually go more smoothly than families imagined possible and are often welcomed by the patient.
"My brother says he’s had it! Is he allowed to quit his treatments and go on hospice?"
Patients who have been through extensive treatment or repeated hospitalizations often become so physically weary that they choose not to continue curative care. Whether or not patients complete their treatment is their choice. They are encouraged to consider hospice care at whatever point they decide to stop aggressive, curative treatment.
"My mother’s physician hasn’t mentioned hospice care. Should we bring it up?"
Yes! Many physicians hesitate to talk about hospice care because they don’t want to destroy a patient’s hope. However, they may actually be relieved if YOU broach the subject. If you feel hospice may be a good option – now or in the future – talk with the doctor about the benefits of curative treatment vs. palliative (comfort) care. Also be sure to discuss your expectations for preserving quality of life so that you share common care goals. If you are hesitant to talk to the physician directly, Center for Hospice Care can help with that communication.
"My father is in the hospital and we wonder if hospice care would be beneficial. Whom do we talk to?"
Hospital social workers and discharge planners should be knowledgeable about the many services provided by Center for Hospice Care and can facilitate a referral to our program. If you haven’t already had direct contact with a social worker, ask your physician, a nurse or chaplain to put you in touch with one.
Center for Hospice Care's admission nurses are available to counsel patients and families whether hospice care is needed now or in the future. Do not hesitate to call us directly with any questions you may have at 574-243-3125.
- Cost & Insurance
Is hospice care covered by insurance?
Yes. Medicare, Medicaid and most other health insurance plans cover all or part of the costs of hospice care. Our staff will work with insurers to see that patients obtain any and all benefits available to them for their terminal illness.
What care and services are usually covered?
Everything required to care for a patient's terminal illness, including the following, as needed:
- Medical and nursing care
- Pain and symptom management
- Drugs and other medications
- Hospice Aide services
- Physical, occupational and speech therapy
- Massage therapy
- Art expression and music therapy
- Medical supplies and equipment
- Social services
- Spiritual support
- Volunteer support
- Bereavement services
What are the charges for staying at one of the Inpatient Units?
For those who have acute care needs that require constant medical management, charges will usually be covered in full under hospice insurance benefits.
Is financial assistance available to those who may need it?
Because of generous contributions from the community, no eligible patient is ever turned away because of an inability to pay. For those who have no insurance or limited financial resources, fees are based on patients' incomes and ability to pay.
How are hospice services covered for nursing home patients?
When nursing home residents choose Center for Hospice Care to provide their care, we will oversee all of their medical care and provide all of the services and equipment needed to manage their terminal illnesses. While Medicare and most insurance plans will cover this, the patient will still have to pay the nursing home's daily room and board fee. (For those on Medicaid, the room and board charge will be covered by Medicaid.)
Please understand: Medicare will not pay for hospice care and "skilled nursing home care" at the same time. When patients are eligible for skilled nursing care benefits - but are considering switching to hospice care - Center for Hospice Care will provide information that will help them evaluate what choice is best for them.
How is hospice care covered on a Medicare HMO plan?
Medicare HMOs do not provide hospice coverage. However, patients can easily turn to basic Medicare for hospice coverage, while still retaining their HMO to cover services unrelated to their terminal illness. For example, if a hospice patient receiving care for terminal cancer falls and breaks a leg, coverage for treating the leg would still be provided by the HMO plan.
How can I receive more information about the costs and coverages for hospice care?
All patients automatically receive assistance from Center for Hospice Care's admission representatives who address the specific financial and insurance needs of each patient. For inquiries prior to admission, contact our Admission Team at 574-243-3125.