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Facts About Hospice Care

Updated on October 04, 2016
Marcy Goodfleisch profile image

Marcy has written about health and wellness for more than five years. She is the former manager of two large clinics in Austin, Texas.

How to Decide When Hospice Care is Needed

Where to Find Hospice Care Services Near You

Each community is different, and there may be a variety of resources for locating hospice care in your area. Some of these may include:

  • The physician handling the case: Chances are, his or her staff has helped refer patients to these services and can help refer you to a hospice provider they've worked with in the past.
  • Hospital Social Services: Many hospitals have social workers on staff who can help direct patients and their families to various services and resources outside of the hospital.
  • Nursing Facilities and Homes: These facilities should be familiar with local hospice care providers and can often provide you with contact information.
  • Insurance Companies: Check with the patient's insurance plan to see if hospice care is covered and whether they have an approved list of providers.

Important Book on Hospice | End-of-Life Care

What is Hospice Care?

In recent years, hospice care has been an important end-of-life addition to the care cycle. In many cases, patients who are in the final stages of a disease can stay at home in familiar surroundings, with loved ones nearby to comfort them. In other cases, Hospice care will be provided at a hospice center, a skilled nursing facility or even a hospital. The individual circumstances of the patient as well as the family will help determine where care is to be given.

Hospice workers visit on a planned schedule to check the patient's basic status, administer certain medications (including IV drugs) and in cases where care is given at home, to make certain more acute care in a facility is not needed. This care is generally called palliative care, or comfort care.

The goal of hospice is to offer a humane and comfortable environment for the patient, and to offer medical, spiritual and psychological help and support to the patient and his or her family at this difficult time. The center of focus is the patient, with a priority on peace, dignity, freedom from pain, comfort and the ability to stay alert and in personal control for as long as possible.

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When Do You Need Hospice Care?

Generally, a patient may enter into hospice care when their life expectancy is six months or less. Often, the physician following the case will introduce the idea of hospice as he or she becomes aware that time is approaching.

Other factors can be considered, such as the desires of the patient to remain at home as long as possible, the ability of the family to be part of the care team if the patient is kept at home and the level of care the patient might need. Patients whose conditions are somewhat stable but declining (meaning there are few, if any, instances requiring immediate medical attention) might be better candidates for hospice in a home environment.

The decision of when and whether to use hospice services for end-of-life care should be made by the patient (if possible), the family and the medical team. The U.S. National Library of Medicine offers information on Hospice Care through its MedlinePlus service.

Hospice Payment Options

How to Pay for Hospice Care

Hospice care can be provided through a number of resources. Since it is often less expensive than hospitalization, many insurance companies provide a degree of coverage for this type of care. Here are places to contact to help find payment options that might apply in your situation:

  • Medicare or other government plans for Seniors: Check the government-provided plan in your country to see what hospice care is included in the coverage.
  • Medicaid: In the U.S., Medicaid can often provide hospice care. Other countries with health coverage based on income or disability may also have this type of coverage.
  • Health Insurance: Many health plans cover hospice care. Be sure to have the full information of the insurance plan when you contact the insurance company. Not all plans within a company offer the same coverage. They will need the policy number and the name and identification number (in the U.S. this is probably the Social Security Number) of the patient. Explain the situation and ask what coverage, if any, is included in the policy.
  • Veterans Administration: If your loved one served in the Armed Forces, hospice care might be available through these services. You will need the patient's military discharge records (in the U.S., the form is called a DD-214) to help determine if the length of service and the circumstances of the discharge allow for coverage.
  • Other Resources: If you are not able to find adequate coverage for hospice care through the above resources, check with state agencies, local social services offices and your place of worship to see if they offer support.

Hospice Care can help during end-of-life transitions

Source

Other End-of-Life Concerns

There are many things to take into account when your family faces an end-of-life situation with a loved one. Here's a brief checklist of some of the things you may want to consider:

  • A living will: Does your family member have personal preferences about the steps they want to be taken in emergencies?
  • DNR: Do you need have forms such as Do Not Resuscitate legally signed and placed in medical records?
  • DNR during Transport: A special form may be required to decline resuscitation during transport (such as in an emergency vehicle). Regular DNR instructions may not apply if the patient is en route to another location.
  • Power of Attorney: If the patient is at risk of declining to the point of not being able to sign the above documents under his or her own power, you should get a Power of Attorney signed. This allows another person (generally a close family member) to make difficult choices regarding life support and other issues you might encounter.
  • A Last Will and Testament: If the patient does not have a signed will, do not delay in getting a valid document prepared and signed. The complications that can arise from lacking a will are expensive, heartbreaking, exhausting and time consuming.

Important tip: Be sure to review all documents to make certain they're being signed and/or witnessed by the proper person. Many documents cannot be witnessed by immediate family members, and many documents require notarized signatures. If you're in a hospital when these documents are being signed and reviewed, there is probably a notary on the staff to help in such situations. Many social service agencies have notaries on hand, and you might also find one through an attorney in your network of friends or at church.

What Happens During Hospice Care?

You are probably wondering what to expect when you arrange for hospice care. Hospice workers are there to help you in a number of ways. In addition to providing medical help, they are skilled in understanding the many emotions the patient and family members are experiencing at this time.

Don't hesitate to ask your hospice worker(s) about how to best support your loved one, what you should and shouldn't do, and where you can turn for additional help. They have been through this time with others, and they have valuable information and experience to share.

You can expect a myriad of feelings through this time. Sadness, grief, fatigue, fear, anger, resentment that this is happening and other very normal feelings. Hospice workers can help address these feelings, and help you feel a sense of peace that you are doing all you can to give your family member love, support and dignity during this transition of life.

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  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Hi, ytsenoh - I'm so glad hospice care provided the love and support your family needed at that difficult time. Thanks for reading and commenting, and for letting us know of your family's experience with the care.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Oh, I'm sorry for the loss of your friend and client, Sharyn - I think it takes a special and sensitive person to care for people who need hospice help; you are surely one of the angels in that calling.

    Thanks for reading and for sharing your personal experience here.

  • ytsenoh profile image

    Cathy 4 years ago from Louisiana, Idaho, Kauai, Nebraska, South Dakota, Missouri

    Marcy, what a great helpful subject you have provided. I've been there, had the experience with an incredible local hospice house and it was heaven on earth for my Dad and our family. Thanks very much for taking the time to share your wealthy advice to people who may need it someday. Thumbs up.

  • Sharyn's Slant profile image

    Sharon Smith 4 years ago from Northeast Ohio USA

    Excellent topic wonderfully written Marcy! I have been taking care of an 87 year old woman in hospice at her home for the past month. Just today, this afternoon, she passed away. How ironic for me to see this hub. There are so many questions by families who are considering hospice for a loved one. Your great article will certainly get them on their way and ease some of the discomfort associated with the end of life process. Really great work as usual!

    Sharyn

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    I like your plan of keeping the documents nearby, Peg - that makes sense; if anything happens suddenly, you don't have to stop and remember to look for them at a stressful and distracting time. Thanks so much for reading and commenting!

  • PegCole17 profile image

    Peg Cole 4 years ago from Dallas, Texas

    Hi Marcy,

    This article is packed full of important information and links to additional material on this difficult subject. So many of us who are caring for our aging parents and relatives are stretched to the limit with all the responsibilities. Being prepared gives us one less thing to worry about when that time comes.

    I keep these forms you mentioned: the Power of Attorney, the Advanced Directive (Living Will), the Medical Power of Attorney and the Last Will in a canvas bag near the door along with a printed list of medicines that my folks take. It saves a lot of repetition when medical emergencies happen.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Hi, Homesteadbound - I so appreciate your thoughts on this subject. I know you are intimately familiar with people who need care, and since you've already experienced a hospice situation, you're even more informed on the issues. Many thanks for reading and commenting!

  • homesteadbound profile image

    Cindy Murdoch 4 years ago from Texas

    I put my father on hospice care, and it was a big help since he was 300 miles away, and he had no one else in the area that could or would help him. Regulations may be different in different areas, and I may have missed it in your article, but once a person enters hospice care here, whatever condition the person has is no longer being treated - as you said, they receive palliative care after that. So, my father had lung cancer, and we were no longer fighting the cancer and moved into a mode of keeping him as comfortable as possible. Great article!

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Thanks, alocsin - I feel the same way - this is a difficult path to travel in your mind. We tend to not want to believe our loved ones are mortal. I'm glad you found useful information here, and I appreciate your comments.

  • alocsin profile image

    alocsin 4 years ago from Orange County, CA

    Not something I like to think about but maybe forced to due to an aging parent. Thanks for laying out the details in a factual manner. Voting this Up and Useful.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    @Ardie - I appreciate your sweet comments! I think it's important for people to know what Hospice Care is, and that it's available. So many of us hear the term but don't really know about it yet. Thanks for reading and commenting!

    @sholland - thanks so much for your kind words; I think you mentioned one of the major factors in selecting a hospice situation for that time of life - the family can be together and be there for the one transitioning as well as for each other. Thank you for sharing your personal experience here.

    @Billybuc - You are always so supportive of people; I'm not surprised you've played a role in helping friends and family through those difficult times. I appreciate your feedback on the hub, and your insight to those experiences.

    @John Sarkis - It's so true that being unprepared only adds to the stress and grief of what is already a heartbreaking time. Thanks for reading, and for your sensitive comments here.

  • John Sarkis profile image

    John Sarkis 4 years ago from Los Angeles, CA

    Marcie, thanks for writing this very informative hub. Facing a loved one's end is a difficult topic for most of us. Nevertheless, it's even more difficult if one is unprepared.

    Voted useful

    John

  • billybuc profile image

    Bill Holland 4 years ago from Olympia, WA

    On several occasions I have been involved with establishing hospice care for friends and loved ones and I can emphatically that these people who do this work are angels sent from heaven. It is amazing the comfort and love that they provide to those who have little time left. Great hub and about a very personal subject for many of us.

  • sholland10 profile image

    Susan Holland 4 years ago from Southwest Missouri

    Marcy,

    This is such an important hub. Thank you for writing it. The different types of hospices are important to be considered. My mother was placed in a nursing home - she only lasted a few hours after the move, but we were all able to be with her. I think that is what is so important about hospice care is that family can be involved. I appreciate the list of how to find out about hospice and who to call for information. My father-in-law passed away last month and his wife has Parkinson's, and we are trying to plan for her future now. We would like and she would like to stay home as long as possible. Hopefully, we will not be looking into Hospice Care for a long time, but it is nice to know where I come for a reference.

    Thanks for writing this valuable information. Votes and shares.

  • Paul Kuehn profile image

    Paul Richard Kuehn 4 years ago from Udorn City, Thailand

    Mary, this is a very good informative hub about hospice care. I lost my mother due to complications from Parkinson's disease about a year ago. She was 90 when she died. During the last two years of her life, my brother and younger sister gave her hospice care while she lived in my younger sister's house. It was especially hard on my brother and sister because mom had to be fed through a tube into her stomach and she could hardly walk. My brother and sister considered bringing hospice workers in, but they decided against it because, as my brother said, it would be too expensive, and the people doing the tube feeding would not do a good job because they wanted to get the chore down the fastest and easiest way. Voted up and sharing.

  • Ardie profile image

    Sondra 4 years ago from Neverland

    This is something not many of us would ever want to face for a loved one yet it is sadly a part of life and the cycle we all deal with. The great idea behind hospice care is that it IS available to help out families who may not be capable of keeping a family member comfortable.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Many thanks, Pamela - it's good to know that wonderful people such as your friends are volunteering for these programs. There are so many things a family must deal with when the need arises for this care. I appreciate your comments and insight.

  • Pamela99 profile image

    Pamela Oglesby 4 years ago from United States

    Hospice is such a wonderful alternative. I think you hub covered the topic extremely well, as even the paperwork is very important. I have some nurse friends who do volunteer work at Hospice and find it very rewarding. Voted up.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Thanks, Alliemacb - I'd not thought about the sense of failure families can feel; you are so right. I appreciate your comments here.

  • alliemacb profile image

    alliemacb 4 years ago from Scotland

    This is a useful hub that gives good information on an emotive topic. Having worked for a cancer charity I know that often loved ones experience a sense of failure when they have to seek help to care for a member of their family who is ill, but hospices provide an invaluable service and excellent support for whole families affected by terminal illnesses. Voted up.

  • Marcy Goodfleisch profile image
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    Marcy Goodfleisch 4 years ago from Planet Earth

    Thanks so much for reading the hub, teaches - I've always heard the same from those I've known who have been around hospice workers. I appreciate your comments here.

  • teaches12345 profile image

    Dianna Mendez 4 years ago

    Some of my friends have had to make this decision with their loved ones. So far, each of them said that they made the right decision. The hospice staff is very professional and knows how to comfort the family and the patient. Your hub provides all the information needed in making this decision and will be valued by many. Voted up.

  • fpherj48 profile image

    Paula 4 years ago from Beautiful Upstate New York

    Thank you Marcy. I appreciate your kindness. I feel a deep void, missing her every day of my life.

  • Marcy Goodfleisch profile image
    Author

    Marcy Goodfleisch 4 years ago from Planet Earth

    I'm so sorry you lost your prcious sister, fpherj - that must have been a horribly painful time for all of you. Thanks so much for sharing that tender memory here, and for your first-hand information on the help and support Hospice Care can offer. Bless you!

  • fpherj48 profile image

    Paula 4 years ago from Beautiful Upstate New York

    Marcy... I have not been faced with needing to arrange Hospice Care. However, my one experience with these incredibly professional and compassionate individuals was several years ago, when I (and my family) lost my precious only sibling, Patty)

    I can say quite sincerely, I don't know what we'd have done without their kindness and support during one of the most profound tragedies in our lives. They are truly Angels on Earth. UP ++

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