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Frequently Asked Questions


General hospice questions

What is hospice?

Hospice cares for people at the end of their life, focusing on the whole person and all of their needs: physical, emotional, social and spiritual. The hospice concept is not new; in fact, hospices have provided comfort, kindness and spiritual nourishment to people in need for hundreds of years. Today’s hospice programs offer that same tradition of comfort to people as they near the end of life’s journey.

Hospice care is provided to those who, in consultation with their physicians, have decided that supportive rather than curative care is desired. The focus of hospice is comfort and quality of life. Despite the association of Hospice with terminal illness, the primary goal is to help people spend their time living as fully and completely as they wish, in their own familiar, comfortable surroundings, and in the company of family and friends.

Patients and their families and friends experience many conflicting emotions when faced with a life-threatening illness -– emotions such as fear, anger, loneliness and anxiety about the future. The hospice team can help both the patient and their loved ones cope with the experience of a life threatening illness in all its dimensions, physical, cognitive, social, emotional and spiritual.

Hospice affirms a person’s right to choice and to be in control of decision-making about their care. It is the role of the hospice team to present and discuss options with the patient and family, and to assist them in making informed healthcare decisions.

Basic to the concept of hospice is an acknowledgment that death is a part of life and a belief that there are opportunities for growth in all stages of life, including the last stage.

Many people think that “hospice” is a particular place, but hospice care can be provided almost anywhere a patient resides: at the patient’s home, or in a retirement home, adult family home, assisted living facility or skilled nursing facility.

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What is palliative care?

Palliative care is a health care approach that focuses on providing comfort, managing pain and physical symptoms, and promoting quality of life, but that does not specifically seek to cure an illness. By providing relief from pain and physical symptoms, palliative care can enhance a patient’s ability to engage in meaningful activities.

Palliative treatments that are intended to improve comfort and quality of life are often compatible with receiving hospice care. This philosophy, called Open Access, focuses on the patient's goals of care. If the patient's goal and the hospice's goal are both optimal comfort and quality of life, in the face of a life limiting condition, palliative treatment serves both the patient's needs and the hospice's mission.

The Open Access philosophy enables Providence Hospice of Seattle to be more inclusive of patients who are benefiting from palliative treatments. Our patients do not have to forego palliative treatments that accomplish their comfort and quality of life goals in order to receive the skilled support and care offered by hospice. Hospice team members work with each patient’s physician to determine which treatments and therapies are appropriate for palliative care.

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Who is eligible to receive hospice care?

Any adult or child who has a life-limiting illness and is no longer seeking curative treatment may be eligible for hospice care. All hospice services are provided in the patient's home or place of residence: nursing home, assisted living, or adult family home.

Hospice care is appropriate for people with almost any type of advanced illness, including cancer, ALS and other neurological conditions, Parkinson’s disease, end-stage Alzheimer’s or dementia, cardiac disease, renal disease, respiratory disease, stroke, AIDS, and so on. Hospice is also appropriate for people who don’t have any one illness causing their decline, but are clearly approaching the end of life.

In addition, Providence Hospice of Seattle is the only hospice in King County to offer pediatric hospice and palliative care to infants, children and teens through our Stepping Stones program.

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How is hospice care paid for?

Providence Hospice of Seattle accepts payment from Medicare Part A (patients with all Medicare HMO programs are eligible for our services), Medicaid and most private insurance plans. We also accept private payment. No one is denied services because of an inability to pay.

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What do the Medicare and Medicaid Hospice Benefits cover?

Medicare has two parts, Hospital Insurance (or Part A) and Medical Insurance or (Part B). Part A covers hospice services and pays nearly all the costs of a patient’s hospice care, which can include:

  • Intermittent home visits by the hospice staff
  • Approved medications for symptom control and pain relief
  • Many types of medical equipment (like wheelchairs or walkers) and supplies (like bandages and catheters)
  • Short-term respite care in a nursing home
  • Authorized outpatient procedures to alleviate symptoms
  • Approved hospitalizations for symptom management
  • Grief and loss counseling

The Medicare Hospice Benefit does not cover the following:

  • Treatment intended to cure a terminal illness
  • Care from another hospice other than the current hospice provider (Providence Hospice of Seattle)
  • Room and board at an assisted living facility, nursing facility or adult family home

Medicaid has a similar hospice benefit, as do most private insurance plans. (Those with private insurance plans should contact the patient’s insurance company’s customer service department for specific information regarding hospice benefits.)

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Where is hospice care provided?

Providence Hospice of Seattle provides hospice care in a patient’s current place of residence. This may be the patient’s home, retirement home, adult family home, assisted living facility or skilled nursing facility.

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When should a decision be made about starting hospice care?

At any time during the course of a life-limiting illness, it is appropriate to discuss all of a patient's care options, including hospice care. In general, the earlier Providence Hospice can become involved with a patient, the more support we can give to both the patient and his or her caregivers.

It may be time for hospice when:

  • Curative treatment is no longer an option, or is no longer desired.
  • The treatment emphasis changes to comfort, pain management and symptom control, and enhancing quality of life.
  • The patient’s physician thinks hospice can help.
  • The patient knows he or she is not going to get well. (Patients sometimes become aware of this before others do.)

If you’re a patient or caregiver who is interested in hospice, please contact us for more information, or ask your physician for a referral. You can also reach us by phone at (206) 320-4000, or toll-free at (888) 782-4445. (Physicans can call our referral line at (206) 749-7701.)

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What is the hospice admissions process?

Any adult or child who has a life-limiting illness and is no longer seeking curative treatment may be eligible for hospice care. Anyone can make a hospice referral. To be admitted to hospice, the patient’s physician must certify that the patient has an estimated life expectancy of six months or less, and the patient has made a decision to seek comfort care only.

If you’re a patient or caregiver who is interested in hospice, please contact us for more information, or ask your physician for a referral. You can also reach us at our referral line (206) 749-7701, or toll-free at (888) 782-4445.

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What to expect at your Admission Visit?

Before the Admission Visit: An Admission Visit may be up to 2 hours long, so being informed will help you prepare for the visit. What you can do to prepare:

  • Review information on our website: http://www.providence.org/hospiceofseattle and discuss hospice with those closest to you. Make note of any questions you have.
  • If the patient is not able to give consent, make sure that the person who has legal responsibility for making healthcare decisions is present at the visit.
  • Have all medications out for the nurse to review and record. This includes any over-the-counter medications that are being used.
  • Have all insurance, Medicare, and/or Medicaid cards available for review.
  • Have copies of any paperwork for advanced directives available for review, including DPOA papers, POLST, and living wills

During the Admission Visit: A Hospice Nurse will make the Admission Visit to meet with both patient and family and/or caregivers, wherever the patient resides. You can expect that the Hospice Admission Nurse will:

  • Explain hospice services and answer your questions.
  • Review patient and family rights related to hospice.
  • Present necessary forms for signature, including the provision of privacy notice, consents for service, and election of insurance benefits.
  • Assist in determining goals for the patient/family and provide educational information about the illness and its effects to help prepare for the future.
  • Provide information about Durable Power of Attorney and Living Wills (there is no requirement to have these in place in order to receive hospice care).
  • Complete an initial physical, mental and emotional assessment.
  • Confirm that hospice is the most appropriate service (meets eligibility criteria).
  • Review medications.
  • Order any necessary medical equipment and supplies.
  • Confer with the Attending Physician, Pharmacist, Medical Director or other team members, as needed, to assist in the development of the plan of care.

After the Admission Visit, the Hospice Care Team Nurse will contact you to schedule a regular nurse visit. Your Hospice Care Team consists of a Nurse, Social Worker, Chaplain, Hospice Aid, and others as needed. You have 24/7 access to our services and can call us anytime at (206) 320-4000 or (888) 782-4445 (toll-free).

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