Hospice Care at Home: Requirements, Expectations, and Cost
Hospice care, also known as end-of-life care, is a convenient choice for terminally ill patients and their families that must be getting through a tough period. The primary goal of hospice care is reducing the patient’s symptoms and improving the quality of their remaining time, but it can’t cure one’s underlying disease.
Hospice care is provided by hospice centers that include interdisciplinary teams of doctors, nurses, pharmacists, social workers, spiritual counselors, as well as volunteers and support groups. Therefore, hospice centers give their best to address all the problems their patients might be facing.
One of the most common forms of hospice care is hospice at home. Although patients can choose a place they want to receive hospice care – hospital, nursing facility, or long-term care facility – they often choose a home. That way, they are under the supervision of their family member and experienced medical team that will regularly visit them and provide additional assistance if needed.
The following post will explain to you more about what you can expect from at-home hospice care, its requirements, and the cost of the service.
What is Hospice Care at Home?
The primary objective of hospice care is to bring physical, emotional, and spiritual support to patients diagnosed with a terminal illness and have less than six months to live. A patient can choose where he/she wants to receive care, and it can be any place that he/she considers home.
A hospice center you’ve chosen will ask you or another family member to be a primary caregiver who will supervise the patient around the clock. Medical teams will regularly visit a patient and his/her caregiver at home and provide any additional help they may need.
What is the Role of Primary Caregiver?
A family member or a close friend that has been chosen to be a primary caregiver usually works together with the hospice team and patient in order to develop a unique care plan based on the patient’s needs and preferences. The primary caregiver will help the patient make decisions and live in the most fulfilling manner possible during his/her last days.
Primary caregivers play the most significant role in at-home hospice care since they provide physical care for the patient and help with keeping records of patient’s symptoms and other issues they might be facing. They will take care of the patient 24/7, but they can rely on the hospice team support always available by phone.
All caregivers will be provided with useful training about giving hands-on care before they start with it.
The fact that a primary caregiver should be with a patient 24/7 may sound inconvenient for patients who live alone or whose family can’t manage to supervise him/her all the time due to work or some other responsibilities. Still, a well-implemented scheduling and good teamwork among friends will be enough to overcome such a problem.
However, hospice team members are aware of such inconveniences, which is why almost every center offers the help of volunteers, who will come and visit the patient and his/her caregiver, providing assistance regarding chores, shopping, running errands, and other duties that form part of the daily tasks. That way, caregivers can get some well-deserved time off.
In case caregivers need some more time off, there is respite care available. It provides caregivers with up to five day-offs, during which the hospice team helps the patient.
Home Health Care VS Hospice
Although home health care and hospice at home seem the same, some critical aspects make them different – for example, the fact that home health care aims at treating a patient’s condition, while hospice only improves the symptoms patients feel due to their disease.
Health care services can also be delivered at home, where nurses, aides, and volunteers regularly visit the patient to help treat the illness, injury, or chronic condition. The most common examples of home health care include:
- Wound care, such as pressure sores and surgical wounds
- Patient and caregiver education
- Intravenous or nutrition therapy
- Regular monitoring of a serious illness and unstable health status
- Physical rehabilitation
- Speech therapy
- Dietary assistance
- Checking and control of blood pressure, temperature, heart rate, and breathing
- Supervising of prescriptions and other drugs
- Pain relief
- Safety management in the home
- Education about self-care
- Communication and care coordination.
Such services are made for treating an illness or injury, helping patients get better and regain independence, and becoming able to perform daily tasks without assistance. Hospice, on the other hand, excludes the services aimed at treating a particular condition and focuses on improving a patient’s symptoms and helping them live better during their last days.
|Durable Medical Equipment||100% Coverage||80% Coverage – Part B|
|Home Services||No Limitation||Must Be Homebound and Require “Skilled” Nursing|
|Services to Nursing Facility Residents||Available||Not Available|
|Medication Related to Primary Diagnosis||Covered||Not Covered|
|Social Services / Counseling||Patient, Family Primary Caregiver||Patient Only|
|Spiritual Services / Care||Covered||Not Covered|
|Bereavement Counseling||Covered||Not Covered|
|Physicial Liability for Fraud (Regulatory Responsibility)||Hospice Responsible for Plan of Care||Physician Individually / Totally Responsible of All Order|
|24 Hour On-Call Services||Covered||Not Required, But May Be Included|
|24 Hour Crisis Care||Available||Not Available|
|Hospice CNA / Home Care Aide||Covered||Covered Part-Time or Intermittent|
|Short Term Inpatient Care||Covered||Not Covered|
|Respite Care||Covered||Not Covered|
|Volunteer Services (Including Transportation)||Included||Not Included|
What are the Requirements for Hospice Care at Home?
To become eligible for hospice care, patients must fulfill some requirements that allow them to enroll in the program. Such requirements often include:
- A proof that the patient’s been diagnosed with a life-limiting condition with a prognosis of six months or less to live if their condition follows its ordinary course
- Frequent hospitalization within the past six months
- Symptoms that worsen (progressive weight loss, for example)
- Weakness, fatigue, and lethargy that don’t cease
- A noticeable change in cognitive and functional abilities
- Difficulties with eating, breathing, dressing, walking, toileting, and continence
- Recurrent infections
- Skin breakdown
- A particular decline in condition.
Patients that suffer from some of the following diseases are often considered eligible for hospice care at home:
- Congestive heart failure
- Liver disease
- Renal disease.
If you don’t think that you’re qualified for hospice care, check whether palliative care is more appropriate for your condition.
What to Expect with Hospice Care at Home?
Hospice care provides absolute peace of mind to both patients and their family, who spends most of the time helping them live as good as possible. When caregivers know that they can rely on the entire hospice team, they feel more comfortable and happier, knowing that their loved one is in good hands.
To begin hospice care, you should sign all the appropriate papers and admissions. Once that’s done, you are officially admitted to hospice care. The hospice team should communicate with the patient’s physician to learn more about a patient’s medical history, symptoms he/she is currently feeling, as well as life expectancy.
When all the paperwork and essential conversations are made, you can expect the following benefits:
- The visits of chaplains and social workers to enhance emotional, psychosocial, and spiritual aspects of the person’s health
- Scheduled and regular visits of individual team members
- Delivery of the necessary medical equipment and medications
- Adequate training for caregivers where they learn how to provide hands-on care to the patients. Caregivers are also encouraged to contact a hospice team whenever they need extra assistance or want to schedule a meeting.
The hospice team finds useful all the information you provide about the condition and symptoms of your loved one. That way, they can develop a practical plan of care, which will be reviewed at weekly team meetings and revised according to the patient’s condition.
Still, hospice services don’t end once the patient’s passed away. Dealing with death may last for a while, which is why families often need emotional support and company to overcome such a period much more comfortable. Therefore, hospice centers usually offer bereavement counseling – it often lasts about a year after someone’s death, and the services are free of charge. Support groups and counselors will regularly check on the family of the deceased and help them improve emotionally.
Who Pays for Hospice Care at Home?
The thing that brings up most of the concerns is the cost of hospice care at home. As much as we want to help our loved ones and make them feel better, money can prevent us from accomplishing our goals and the wishes of our family members.
Medicare distinguishes four levels of hospice care, and it covers all of them 100%.