Hospice Care Explained: How Does it Work, Benefits, and Cost
When your loved ones have been diagnosed with a severe terminal illness and a life expectancy of six months or less, hospice care becomes one of the best choices you can have. The primary purpose of hospice care is to help a dying patient spend his/her last days in the best possible way, surrounded by friends and family.
Hospice care is applicable when patients and their families decide to give up curative treatments, which are no longer effective. That said, patients won’t be receiving any medicines that could help them improve their underlying condition, but they will be given treatments aimed at increasing the quality of life. Patients and their families can expect the assistance of a multidisciplinary team that consists of physicians, therapists, social workers, and even spiritual counselors.
Hospice brings a lot of benefits to both patients and their families, and it’s most significant advantage can be the fact that Medicare, Medicaid, or Medi-Cal entirely cover the services.
What is Hospice?
Hospice care is a service provided by hospice centers that aim to provide support to patients and their families during one of the most challenging periods of their lives. One of the requirements that patients need to meet is proof that they’re terminally ill and that their life expectancy doesn’t surpass a six-month period. Additionally, they must give up their curative treatments in order to enroll in hospice care.
Patients and their families can choose whether they want to receive care at home or somewhere else (a nursing home, an extended care facility, etc.). No matter what place they choose, they will get the ultimate care provided by a professional team of physicians, nurses, social workers, counselors, chaplains, volunteers, and support groups that will always be there to help.
What are the Most Common Hospice Programs?
Hospice care is often provided at home, but there are cases where patients and their families decide to receive care in a nursing home or facilities owned and operated by hospice centers. Either way, hospice care is provided on the four levels, and each of them includes the team of experienced staff that consists of:
- Physicians: Hospice patients can choose their primary physician, who can be either their prior doctor or the one provided by a hospice center.
- Home health aides: The services provided by home health aides include additional support for routine care (bathing, dressing, and eating).
- Nurses: A team of nurses is responsible for the coordination of the hospice team, and they come to a patient’s home or any other facility where the patient is to help them and their caregivers.
- Pharmacists: Pharmacists will oversee the medications, provide suggestions, and recommend the most efficient methods for relieving the patient’s symptoms.
- Social workers: Social workers are there to provide counseling and support, as well as referrals to other support systems.
- Spiritual counselors: Hospice teams also aim to fulfill the patient’s spiritual needs, which is why they provide spiritual counseling that includes chaplains, lay ministers, priests, rabbis, and more.
- Volunteers: Every hospice center has groups of volunteers adequately trained to provide care and help caregivers with household chores, shopping, transportation, respite, or just be their company.
- Bereavement counselors: Counselors that provide bereavement support will be there to help families overcome the death of their loved one.
- Other professionals: You may rely on speech, physical, and occupational therapies created for improving the patients’ abilities to speak and perform everyday tasks.
1. Routine Home Care
Routine home care is defined as the basic level of care, and it includes scheduled visits in the home by an interdisciplinary team of physicians, nurses, aides, social workers, chaplains, volunteers, and bereavement specialists. Since it’s provided at home, a hospice team will ask a patient’s family member to be their caregiver. The role of a caregiver is to supervise and take care of the patient 24/7, but they can rely on the hospice team’s help whenever they need it.
Routine home care often includes:
- Skilled nursing services
- Physical and occupational therapies
- Speech-language pathology services
- Medical services
- Home health aide services
- Medical supplies for use at home
- Durable medical equipment (blood sugar monitors).
2. Continuous Home Care
When routine home care is no longer an adequate solution, continuous home care is something you need to consider. Continuous care is suitable when you need medical supervision for at least eight hours in a 24-hour period since a patient’s symptoms begin to worsen.
Symptoms that may require continuous home care are:
- Unrelieved pain
- Severe nausea and vomiting
- Shortness of breath
- Panic attacks or anxiety.
3. Inpatient Care
Patients sometimes have symptoms so severe that they can’t get adequate hospice care at home. Such situations usually require inpatient care, which is received in an inpatient facility where patients can get proper treatment for their severe symptoms.
Symptoms that require inpatient care are mostly those treated with continuous care, but the crucial difference lies in the setting of care. Inpatient care includes around-the-clock assistance of nurses that provide medications, treatments, and emotional support to make the patient feel better.
Inpatient facilities where patients often get hospice care are:
- A free-standing facility owned by a hospice company
- A hospice unit within a hospital
- A nursing home.
4. Respite Care
Respite care is more aimed at a family of the patient than at the patient. If a patient for some reason doesn’t qualify for continuous or inpatient care, and family can’t provide enough care due to the stress or some other circumstances, a hospice center may offer respite care. That way, a patient may be temporarily admitted to an inpatient facility so that their caregivers (family) can take some rest.
Note that there is a five-day limit on respite care. Once it expires, the patient will return home.
What to Expect from Hospice Services?
Hospice centers provide more than just hospice care. They usually offer programs such as palliative care, family meetings, bereavement services, and other types of assistance patients and their families will find useful.
A term palliative care is often mentioned together with hospice, but there is a significant difference between these two types of support. Unlike hospice, which is aimed only at those patients that have six months or less to live, palliative care can be provided at any time. Besides, patients don’t need to give up their curative treatments, but they can receive palliative care together with therapies for their underlying condition, which is not the case with hospice.
The goal of palliative care is to mitigate the patient’s symptoms, help to navigate treatment options and provide emotional, physical, and spiritual support. It shares more or less the same ideas as the hospice philosophy, which means that its purposes are directed toward making a critically ill patient feel better.
The best thing about hospice and palliative care is the fact that you can count on the around-the-clock assistance of the professional medical staff whenever you and your loved one need it. Almost every hospice center has someone on-call, who’s available 24/7 and who can send you out a medical team to help you at any time.
Hospice teams encourage the families of terminally ill patients to attend family meetings, where they can talk to nurses, counselors, or social workers and express their emotions and concerns. These meetings will allow families to keep up with their loved one’s condition, telling them what to expect. That way, they will be able to learn more about death and the process of dying, which is essential for accepting the inevitable future of their loved one.
The period that comes after the patient’s death can be quite painful for the family, which is why they may want to consider bereavement care. Bereavement care is often provided for 13 months after a person’s death, and families can receive it via visits, phone calls, or meetings with support groups offered by a hospice center. Bereavement care is entirely free.
Does Medicare Cover Hospice?
Who pays for hospice care at home? is one of the most asked questions associated with hospice services. Such a concern is quite reasonable since families are often afraid of the high costs of treatments they might not be able to pay. The good news is that Medicare, Medicaid, and Medi-Cal entirely cover hospice care.
Medicare will cover all the costs associated with hospice services, including medical equipment, medications, oxygen, products for personal and wound care, and other supplies that a patient may need. Still, you may need to pay a copayment of no more than $5 for each prescription drug and product for pain relief and symptom management while you’re at home.
Other services that may be covered by Medicare include:
- Doctor services and nursing care
- Medical equipment (wheelchairs or walkers) and medical supplies (bandages and catheters)
- Hospice aide and homemaker services
- Services of physical, occupational, and speech-language therapies
- Social work services
- Dietary counseling
- Bereavement counseling for a patient’s family
- Short-term inpatient care
- Short-term respite care (up to 5 days)
- Any other services recommended by your hospice team that are related to your terminal illness.
However, you should know that Medicare won’t cover any of the following services once your hospice benefit begins:
- Treatments aimed at improving the patient’s terminal illness or related conditions
- Prescription drugs for curing the underlying illness
- Care provided by a hospice center that wasn’t set up by your hospice team
- Room and board if you get hospice care in your home or nursing facility
- Care you receive as a hospital outpatient unless your hospice team arranges it.
Conclusion – Is Hospice a Good Choice?
Although it’s mostly perceived as a pessimistic move, hospice care is quite an adequate solution for dying patients that want to spend their last days surrounded by friends and family. The entire hospice team does their best to improve the quality of the patient’s end-of-life journey and help them reduce the symptoms of pain and emotional stress, which is another reason why hospice care is worth considering.
Another vital benefit of hospice care is the fact that it’s free of charge, which makes it convenient for every citizen. Don’t see hospice as something as the result of giving up but provide yourself and your loved one with the opportunity to see things in a different light.