How To Find Hospice Care
Understanding hospice care
Hospice is a concept of care not, as some may think, a specific place. It involves a special system of supportive services, including pain and symptom management, social services, and emotional and spiritual support for the terminally ill and their families. The hospice objective is to promote the quality of life remaining.
A patient and family may turn to hospice care when the goals of patient care have switched from curing to comforting. Any individual of any age with any diagnosis of a terminal disease may turn to hospice.
Receiving hospice services
Reimbursement sources, such as Medicare, Medicaid, or private insurance, generally require a prognosis of six months or less for services to be covered. In addition to traditional medical hospices, there is also a non-medical hospice program in Montgomery County that offers practical and emotional support for patients with a year’s prognosis or less who may choose to continue their curative treatments.
Hospice is unique in that care and support are provided to the entire family, not just the patient. A team of skilled professionals and volunteers work to serve the special needs of the individual patient and family. Choice is at the center of the hospice approach – a person faced with a life-limiting illness is encouraged to remain independent and in control of his or her life.
Hospice care is usually provided in the patient’s home or the home of a loved one. Many hospice patients live out their lives in the comfort of familiar daily routines, surrounded by their treasured possessions and their friends and families. However, hospice services may be provided in long-term care facilities or in-patient hospice residential settings.
Choosing a hospice provider
Once you have decided that Hospice is the right care option for you or your loved one, there are a number of issues to address before choosing a specific program or provider. The best way to find a quality hospice provider is through a recommendation from a friend, family member, or health care professional-such as a social worker or hospital discharge planner.
While deciding on the program that is right for your family, look into any accreditations, certifications, or licensures that the program has received. JCAHO (Joint Commission on Accreditation of Healthcare Organizations) is a not-for-profit organization that provides accreditation for health care organizations and programs. You can contact them at 630-792-5000 or www.jcaho.org for more information about specific programs.
Whether or not the program is Medicare certified is also important. Programs certified by Medicare have met certain minimum requirements for operation. According to Caring Connections, a consumer education program provided by the National Hospice and Palliative Care Organization (NHPCO), “More than 90% of hospices in the United States are certified by Medicare. Medicare defines a set of hospice core services, which means that hospices are required to provide these set of services to each person they serve, regardless of the person’s insurance.” If your state has licensure requirements, inquire to ensure that the provider has met all those requirements.
After establishing that an agency meets certain minimum requirements, request that they send you any brochures or written materials; specifically request information on services, costs, payment procedures, and liability insurance coverage. Ask if the provider can supply references from professionals in your community. Before arranging for services or signing a contract with any specific provider, you may want to consider the questions in the box above.
Services provided by hospices
Hospice team members focus primarily on managing the patient’s pain and symptoms. Medication, medical supplies, and equipment are all provided to make the patient more comfortable. Other services, such as speech and physical therapy, are available should they become necessary. If managing pain and symptoms in the home environment becomes impossible, hospice providers can offer short-term inpatient care.
Hospice providers also teach family members how to properly care for the patient. Additionally, information and support is available to help patients and families deal with the emotional, psychosocial, and spiritual aspects of dying. Surviving family members and friends will receive bereavement care and counseling from the hospice professionals.
Paying for hospice care
Most hospice services are fully or partially covered by Medicare, Medicaid, private insurers, or prepaid health plans. The non-medical Hospice services available in Montgomery County are offered free of charge and are delivered by a staff of trained volunteers. For traditional Hospice services, financial assistance is available for those unable to pay for care.
NHPCO notes that, “Eighty percent of people who use hospice care are over the age of 65, and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the patient or family.” In order to receive the Medicare Hospice Benefit, patients must be eligible for Medicare Part A, have a terminal disease or condition with a less than six months prognosis, sign a document certifying that they are choosing hospice care instead of routine Medicare benefits for their illness. Patients may only receive covered benefits from a Medicare-approved hospice program. In addition to Medicare’s coverage, hospice services are also generally covered by Medicaid or private insurers.
For more information, see Caring Connections website at www.caringinfo.org or the American Cancer Society’s information on hospice care at www.cancer.org.