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Frequently Asked Questions

The prospect of hospice care raises a lot of questions in people's minds. Below are some of the most frequently asked questions we hear with answers that we hope will help you and your family.

What exactly is hospice care?
Where is hospice care provided?
Does hospice provide caregivers?
Who pays for hospice. Is it covered by my insurance?
When should a decision about entering a hospice program be made and who should make it?
If I start hospice, can I keep my physician?
Can I be on hospice and still get chemotherapy and radiation?
Can I have hospice if I'm living alone, without caregivers to help me?
What would happen if I'm on hospice and need to go to the hospital? Would hospice still be involved?
How does hospice "manage" pain?
What success rate does hospice have in helping patients manage their pain?
Will medications prevent me from being able to talk or know what is happening?
Does hospice pay for medications for everyone? Are all medications covered?
What happens if I "outlive" my 6-month prognosis? Can I still stay on hospice?
What happens if my condition improves?
Why would a person stop receiving hospice care?
What happens if I linger for months and months? Can hospice help me die?
Does hospice provide help to families after their loved ones have died?

What exactly is hospice care?

Hospice care is for people who have a limited life expectancy (6 months or less) and have decided to shift the focus of their care from cure to comfort. Hospice emphasizes the quality of remaining life, allowing people to stay in familiar surroundings with their loved ones while receiving the health care and support services they need (including pain and symptom management). The hospice team consists of medical directors, nurses, hospice aides, social workers, chaplains, volunteers, bereavement counselors and others who support the physical, emotional, social and spiritual needs of patients and their families.

Services include:

  • Regular home care visits by registered nurses and licensed practical nurses to monitor patient conditions, educate caregivers, provide appropriate care, and maintain patient comfort.
  • Hospice aide services for personal care such as bathing.
  • Social work and counseling services.
  • Chaplain services for the patient and/or loved ones.
  • Bereavement counseling to help patients and their loved ones with grief and loss.
  • Pain and symptom management.
  • Education of disease process, coping skills and care planning.
  • Physical, occupational and speech/language therapy, if needed.
  • Dietary counseling.
  • Physician services, provided either by the patient's personal physician or a physician affiliated with a hospice program.
  • Volunteer support to assist the patient and loved ones.24-hour "on call" availability for questions and care as needed.

 

Where is hospice care provided?

Care is provided in a person's place of residence. While most patients live in their own homes or those of family members, some reside in adult family homes, assisted living facilities or nursing homes. Hospice insurance benefits do not cover expenses for room and board.

Does hospice provide caregivers?

Hospice does not provide caregivers. Hospice staff visit you in your home or residence to provide care on an intermittent basis. How often staff visit (and what staff are involved) varies from person to person based on individual care needs. Hospice staff, especially our social workers, can help you and your family identify care options if additional help is needed.

Who pays for hospice? Is it covered by my insurance?

There are a number of options for payment, including Medicare, private insurance, Medicaid and private payment. Each situation is different, so our hospice staff work with you, your family and your insurer to help you determine what benefits and coverage are available.

When should a decision about entering a hospice program be made and who should make it?

You and your family should feel free to discuss hospice care with your physician or health care provider any time you think it may be appropriate or desirable during the course of a life-limiting disease. It is important at such times to discuss all care options, including hospice. Most physicians know about hospice. If your physician wants more information about hospice, it is available from Providence SoundHomeCare and Hospice (360) 493-5900 as well as the Academy of Hospice Physicians, medical societies and state hospice associations (in Washington State, it is the Washington State Hospice Association). Good web-sites to explain hospice care include The National Hospice and Palliative Care Organization www.nhpco.org, The Hospice Foundation of America www.hospicefoundation.org, and Hospice Net www.hospicenet.org.

By law, the decision whether to elect hospice services belongs to the patient (assuming he or she has a qualifying diagnosis). Understandably, most people are uncomfortable with the idea of stopping all efforts to "cure" a disease. Hospice staff members are highly sensitive to these concerns and are available to discuss them with you and your family. The ultimate decision is always up to you.

If I start hospice, can I keep my physician?

Yes. Personal physicians are an important part of the hospice team approach. Your physician provides the initial diagnosis and referral, which initiates the hospice evaluation process. Your physician stays involved throughout your care. While the hospice team provides your day to day care, your physician continues to be available to you and your family and works with hospice staff to ensure that you get the best care possible.

Can I be on hospice and still get chemotherapy and radiation?

The primary focus of hospice care is comfort, not curative measures. People often come to hospice care after methods such as chemotherapy and radiation have been tried and have failed to stop the progressive course of a disease. Thus, chemotherapy and radiation are not normally indicated or ordered within a hospice plan of care. Remember, however, that you are always free to change your mind and renew active treatment. You just need to revoke hospice care. You can always come back to hospice later if your intentions change.

Can I have hospice if I'm living alone, without caregivers to help me?

Yes. The important thing is that you are able to care for yourself and meet your needs. People who live alone often come onto hospice service and do fine. However, as your needs change during the course of hospice care, you or your family will need to find caregivers to help you remain safe in your home or consider alternative living arrangements. Hospice staff can help you in this process.

What would happen if I'm on hospice and need to go to the hospital? Would hospice still be involved?

The focus of hospice is symptom management and patient comfort. Most often this can occur in the patient s residence. Hospice staff work with family and caregivers to prevent pain and discomfort and help people stay out of the hospital. In some instances, however, symptom management may require hospitalization. Hospice staff will assist you in the unlikely event this situation occurs.

How does hospice "manage" pain?

Hospice staff members believe that emotional and spiritual pain are as real and as in need of attention as is physical pain. Thus, we address all facets of pain. Hospice nurses and physicians are up-to-date on the latest pain medications and procedures. In addition, counseling and spiritual support are available to help patients and their loved ones deal with emotional and spiritual pain.

What success rate does hospice have in helping patients manage their pain?

Very high. Most people receiving hospice care feel comfortable and enjoy a good quality of life. To achieve this, hospice staff use a variety of combinations of medications, counseling and therapies.

Will medications prevent me from being able to talk or know what is happening?

Not usually. We work very hard to help people in our care remain pain free, but alert. By working closely with you and your family, we are usually very successful in reaching this goal.

Does hospice pay for medications for everyone? Are all medications covered?

Your insurance coverage determines whether hospice pays for medications. For instance, the Medicare and Medicaid Hospice benefit covers medications used to treat pain and other symptoms. Our staff can help you and your family understand your insurance benefits.

What happens if I "outlive" my 6-month prognosis? Can I still stay on hospice?

People do sometimes "outlive" their prognoses, which is often reason for celebration, especially if they are receiving good care and enjoying an enhanced quality of life. What happens at that point depends upon the unique circumstances of each situation. Sometimes people outlive their prognoses but their disease processes continue, so it is appropriate for them to continue on hospice service. Sometimes, however, people improve after receiving hospice care. In these cases, it may be appropriate for them to discontinue hospice care to enjoy the months or years of life they have remaining.

What happens if my condition improves?

It is not unusual for people to feel better after coming on hospice care. In some situations the disease process seems to halt and may even reverse course. Hospice staff will share their observations with you and review your care options with you should this occur.

Why would a person stop receiving hospice care?

Patients have the right to stop receiving hospice care at any time, for any reason. In addition, sometimes their health improves or their illnesses go into remission while receiving hospice care. When patients' conditions become stable to the point that they can no longer be certified as terminally ill (having a life expectancy of six months or less), they are no longer eligible for the hospice benefit. However, they can always return to hospice care in the future should their conditions change and they once again meet eligibility criteria.

What happens if I linger for months and months? Can hospice help me die?

No. Hospice does nothing to either speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge during the dying process. Hospice care focuses on comfort and palliative care. We work hard to ensure that people have the best quality of life with their loved ones for whatever amount of time they have granted to them. That said, it is often difficult for patients and their families when patients linger for months, ready to die. If this happens, hospice staff work hard to help patients continue the highest quality of life possible. Many times, this involves helping patients resolve "unfinished business," such as personal or family issues, seeing loved ones or saying good-byes. We continue our care and our service for as long as patients continue to meet hospice eligibility guidelines.

Does Hospice provide help to families after their loved ones have died?

Yes. Hospice cares for both patients and their families. Care for bereaved family members continues after loved ones die and includes grief counseling, support groups and written materials explaining the grief process. For more information about these services, see Bereavement Services.

If you need more information, would like to refer a patient, or request a free consultation, please call us at (360) 493-5900 or (877) 620-3286.