Frequently Asked Questions
Hospice is a form of care tailored specifically for the needs of individuals and families facing a life-limiting illness. A diverse medical care team works together to manage pain, increase comfort, and support every aspect of a patient’s physical, emotional, and spiritual health. The goal of Hospice Care is to help people live their last days with respect, peace and dignity.
Most families choose Hospice Care when a loved one is diagnosed with an illness that can’t be cured. We recommend speaking with your loved one’s physician to discuss care options. If they believe that Hospice Care is the right choice, they’ll provide a referral. We are also available to speak with you about care options, and to coordinate with your loved one’s physician. If the patient does not have a physician, we are able to provide a referral. Click here for contact information.
Ideally, hospice should be considered when a loved one has an incurable condition that no longer responds to curative treatments. Families often report that they wish they had elected the hospice benefit sooner in their disease process. Articulating your wishes with your loved ones through advanced care planning can help you and your medical provider identify the need for hospice services sooner.
In general, care and end-of-life discussions should begin as soon as a patient is diagnosed with a life-limiting illness. The best way to determine if Hospice Care is the right decision is to discuss with the patient’s doctor. If the patient does not have a physician, we are able to provide a referral.
End-of-life care may be difficult to discuss, but it is best for family members to share their wishes long before it becomes a concern. By having these discussions in advance, patients won’t be forced into uncomfortable situations. Advanced planning helps patients make an educated decision that includes the advice and input of family members and loved ones. Also discuss with the medical director, and/or admission nurses.
We can be a resource for you, also. We’re available to answer any questions you may have. Click here for contact information.
Examples of life-limiting illnesses include:
- Alzheimer’s Disease or Dementia
- Parkinson’s Disease
- Heart Disease
- Pulmonary Disease
- Liver Disease
- End-stage Renal Disease
- Protein Calorie Malnutrition (or debilitating malnutrition)
A life limiting illness, coupled with symptoms like the ones listed below, could be indicators of decline and hospice eligibility:
- Frequent hospitalizations, ER visits, or visits to the physician within the last six months
- Progressive weight loss (with consideration to weight gain factors such as edema, when applicable)
- Decreasing appetite
- Dysphagia or difficulty swallowing
- Increased weakness or fatigue
- Decline in cognitive status or functional abilities
- Increasing assistance needed with Activities of Daily Living (ADLs)
- Increasing pain or increasing difficulty in controlling pain
- Increasing dyspnea or shortness of breath
- Oxygen dependency
- Reoccurring infections
- Increased nausea and/or vomiting that is difficult to control
- A desire to forgo future hospitalizations
- A request to discontinue treatment
- Recurrent or frequent infections
- Skin breakdown
- A specific decline in condition
If you or a loved one has a life-limiting illness and are experiencing any of the above symptoms, consider speaking to your physician about hospice services. Anyone may request or inquire about hospice services, but hospice must be ordered by a physician. Call Springhill Home Health and Hospice today at (251) 725-1268 and one of our team members can guide you through the process of requesting hospice through your physician.
It is important to have advanced care plan conversations with your physician and your family so that both can respect and follow your health care wishes. If your physician is not leading these conversations, it is appropriate for you to do so. Anyone can request or recommend hospice services, but a physician must write an order to initiate hospice care. If you have questions about hospice services, call Springhill Home Health and Hospice. Our team can discuss the benefit with you at any time. Our team can contact to your physician to guide the process of obtaining an order for a hospice assessment.
For many, the most comfortable atmosphere is ‘home’. 95% of hospice care is provided in patient homes, but Hospice Care can be provided at the location that is most suitable for each individual and family. We understand that in some situations, a family may need to keep their loved one in a hospital setting. Hospice Care can be provided at the location that is most suitable for each individual and family.
If a patient meets the qualifications for hospice, the patient typically has a life expectancy of six months or less if the disease follows its normal projected course (without major medical intervention.) However, a study sponsored by the National Hospice and Palliative Care Organization found that patients who elect hospice care lived an average of one month longer than those who did not elect hospice care. If a patient still meets the qualifications for hospice services after six months, the hospice medical director and physician can re-certify that a patient is still terminally ill, and the patient can continue to receive the hospice benefit.
Hospice helps patients manage their pain and symptoms and can offer support to improve the entire family unit’s physical, spiritual, and emotional well-being. Hospice can also decrease the financial burden of caring for a loved one at home by providing medications related to the hospice diagnosis, medical equipment, and supplies in addition to supplemental nursing, aide, social worker, chaplain and bereavement, and volunteer services. Hospice can also reduce the wait and expense of time spent at doctor appointments or the emergency room.
Most health plans cover Hospice, including Medicare, Medicaid, and private insurance. Even if an individual doesn’t have insurance, hospice is still an option. We will not turn away any patients who need comfort and care during the last stages of their lives.
We maintain close contact with a patient’s primary care doctor. We want patients to feel as comfortable as possible, so we do our best to ensure they’re able to see doctors they already know and trust.
Our staff works closely with families to coordinate individualized care plans. Our team of experts will schedule visits according to that plan. All supplies that are part of treatment and comfort care are provided as needed. Our staff is available 24/7 to respond to emergencies, answer questions and offer support.
Most hospices have nurses available to respond to a call within minutes, and some hospice programs have chaplains and social workers on call, as well. When appropriate, and if ordered by the physician, we will provide 24-hour care.
Hospice care can begin as soon as the patient’s doctor makes a formal request or ‘referral’. A hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient, family, and/or primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.
Each hospice recipient has an individualized care plan, which means that the services that are provided are unique to the needs of that individual. These needs, which are assessed upon admission and at each nursing visit afterwards, will determine how often the hospice team will visit. Visit considerations will be based on the physical, emotional, and spiritual needs of the patient as well as the preferences of patient and their family. Typically speaking, most patients will receive a nurse visit at least two times a week, an aide visit two to three times a week, a social worker and chaplain visit once a month, and volunteer and bereavement services as needed. A change in the needs of the patient or caregiver can warrant an increase in the number of visits necessary for the patient. Some patients only wish to receive a visit from the nurse once a week; other patients require daily nursing visits. Hospice is designed to increase services as the needs of the patient and family increase, which is why the nurse will assess the patient and family’s needs at each visit.
Every hospice patient has access to a hospice volunteer, registered nurse, social worker, home health aide, and chaplain (also known as the interdisciplinary team). The interdisciplinary team writes a care plan with the patient and family that is used to ensure all parties receive the care they need. All visits are based on patient and family needs as described in the care plan, and the condition of the patient during the course of the illness.
Hospice does not mean giving up. Hospice is simply a different type of medical care, where the focus shifts from curative treatment to comfort treatment. Hospice neither hastens nor postpones death. A common misconception is that hospice discontinues all medications and does not treat infections, both of which are false. The hospice nurse, under the direction of the hospice medical director, will make suggestions or recommendations for additional or alternate medications that will alleviate pain or symptoms. Hospice focuses on quality of life, with an emphasis on providing physical, emotional, and spiritual services that will support the patient and family’s ability to living life to the fullest in the remaining months, weeks, or days.
Many patients may have pain and other serious symptoms as their illness progresses. Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. Since keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure the patient’s level of comfort during their hospice stay. Hospice staff works with the patient’s physician to ensure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan. The care plan is reviewed and updated frequently to reflect new goals and changes.
Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to the care and services provided by the care facility. The hospice and the care facility will have a written agreement in place.
Hospice volunteers are available to provide support to patients and their loved ones, including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members.
Since hospice volunteers spend time in patients’ and families’ homes, each hospice program has an application and interview process to ensure each volunteer is well suited for this type of work. Hospice programs also have an organized training program for their patient care volunteers. Areas covered by these training programs include understanding hospice care, maintaining confidentiality, listening skills, identifying signs and symptoms of approaching death, coping with loss, grief, and bereavement support.
If a patient’s health improves during hospice care, the hospice team may discuss an alternate service, such as home health. If the patient’s health deteriorates or worsens at a later time, the physician can write an order for hospice to re-evaluate for hospice services. If the Medicare qualifications for hospice are met, the patient can elect to resume hospice care.
If the patient cannot stay at home due to an increasing care need, and requires a different place to stay during the final phase of life, a growing number of hospice programs have their own hospice facilities, or have arrangements with freestanding hospice houses, hospitals, or inpatient residential centers to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life. However, care in these settings is not covered under the Medicare or Medicaid Hospice Benefit. It is best to find out well before hospice may be needed if insurance or any other payer covers this type of care.
It is time to consider hospice when:
- treatment is no longer effective
- the side effects of treatment outweigh the benefits
- frequent medication changes are necessary
- the patient no longer wishes to return to the hospital
- the patient or family needs extra assistance
- additional visits and/or services are needed beyond the scope of home health
Yes. Hospice programs must meet state licensure requirements in order to provide care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards, and to maintain their operating license.
Many hospices use tools to determine how well they are doing in relation to quality hospice standards. Most programs use family satisfaction surveys to get feedback on their programs. To help hospice programs ensure they are providing quality care and service, the National Hospice and Palliative Care Organization has developed recommended standards entitled ‘Standards of Practice for Hospice Programs’.
There are also voluntary accreditation organizations that evaluate hospice programs. These organizations survey hospices to find out if they are providing care that meets defined quality standards. These reviews take into account the customary practices of the hospice, such as policies and procedures, medical records, personal records, and evaluation studies. In many cases, the reviews include visits to patients and families who are currently under care of that hospice. A hospice program may request to obtain accreditation from one of these organizations.