What is hospice care?
ospice is nursing and supportive care for people at the end of life that is provided in a home-setting, usually the patient’s own residence. It involves a team of healthcare professionals and volunteers, all working together to secure the patient’s comfort and to support the family in their decision to have the patient at home. The care is managed by a registered nurse who visits regularly to check on the patient. The nurse teaches the family how to manage the patient’s care between visits. Depending upon the needs of the patient and family, other team members may include a home health aide for personal care, a medical social worker to help with emotional issues; a chaplain for spiritual care, a trained volunteer to help with a family’s more practical needs, such as sitting with a patient while the caregiver goes to an appointment, and physical or occupational therapists. As the registered nurse coordinates the patient’s care and team services, he/she also is in regular contact with the patient’s physician and the hospice medical director. The focus of the care is on pain and symptom management, and to ensure the patient’s dignity in the privacy of his or her home.


How is hospice care paid for?
edicare, the Federal government health care reimbursement program for those over the age of 65, has a benefit that covers hospice care 100 percent, including medications and equipment that are related to the terminal illness. Most private insurance companies mirror the Medicare Hospice Benefit. There is usually no out-of-pocket expenses for the family. Medicaid coverage varies by state.


What about if patients have another condition, such as diabetes, that requires a variety of medications and equipment?  Are those covered too?
f the condition is the reason the patient has come on to hospice care, it most likely will be covered. In some cases, secondary conditions can be justified for coverage under the Medicare Hospice Benefit The hospice care provider and the patient’s physician make that determination.


How is someone eligible for hospice care?
nder Medicare rules and many private insurance plans, a physician first must certify that the patient’s condition will cause his or her death sometime within the next 180 days, or six months. The patient is no longer seeking active, curative therapies, opting instead for palliation which addresses pain and symptoms and other comfort measures.


How is hospice care different from other types of care?
ospice care is about maintaining control over the decisions that affect the end of life process. In a hospital, where 75 percent of deaths occur, everything—the environment, the equipment, the food, the nurse, the doctor—is controlled. The dying loved one and his family generally don’t control the process. Hospice care is just the opposite. It honors the wishes of the patient and family. It is ingrained in the hospice team and within the hospice concept of care.


For more information and resources, check out the nhpco.org website.