Q: When should a decision about entering a hospice program be made?
A: At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.
Q: Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
A: The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
Q: Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
A: Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
Q: What does the hospice admission process involve?
A: One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Most hospices have medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.
Q: Is caring for the patient at home the only place hospice care can be delivered?
A: No. Although 90% of hospice patient time is spent in a personal residence, some patients live in nursing homes or hospice centers.
Q: How does hospice “manage pain”?
A: Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish. Various counselors, including clergy, are available to assist family members as well as patients.
Q: Will medications prevent the patient from being able to talk or know what’s happening?
A: Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
Q: Is hospice affiliated with any religious organization?
A: No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
Q: Is hospice care covered by insurance?
A: Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 39 states, and by most private insurance providers. To be sure of coverage, families should check with their employer or health insurance provider.
Q: Does hospice provide any help to the family after the patient dies?
A: Hospice provides continuing contact and support for caregivers for at least a year following the death of a loved one. Most hospices also sponsor bereavement groups and support for anyone in the community who has experienced a death of a friend or family member.