6 Things to Know About Hospice Care

By Dr. Amy Schiffman

For some, the word “hospice” may invoke negative emotions. However, the hospice “benefit” is perhaps the most unique, collaborative, and comprehensive type of care for someone at end of life or with advanced illness.

Hospice is not just for patients who are actively dying. Instead, hospice is designed for anyone who may have less than six months to live. This means that patients with dementia, cancer, or heart disease can often be on hospice for many months.

According to a recent study, less than half (47 percent) of Medicare decedents received one day or more of hospice care and were enrolled in hospice at the time of death. Anecdotally, for those who enter hospice, many have not done pre-planning for their end-of-life care, including establishing Powers of Attorney or funeral planning.

It is clear there is a real opportunity to educate and inform the public about the benefits of hospice. Here are six things those in the end-of-life and deathcare industry should know about hospice:

1. Patients receive care from a team.

This team usually includes a medical director, case manager, chaplain, social worker, home health aide, volunteers, and bereavement specialists. This interdisciplinary team meets at minimum every two weeks to discuss each patient’s care. There is no other service in the U.S. healthcare system that provides this type of wraparound and collaborative care.

Since many patients have not pre-planned for funeral or other end-of-life arrangements, the team is often responsible for walking a patient or a family through funeral home selection and funeral planning details. Because of this team-based approach, the family and any loved ones are also supported. After someone dies, the hospice will usually provide bereavement services up to 13 months free of charge.

2. Hospice services are generally free of cost to the patient.

Medicare and most commercial insurances pay for hospice services at 100 percent, as long as someone continues to meet eligibility requirements. The hospice benefit includes not only the interdisciplinary team support, but also certain medical equipment, medications, and supplies. The ultimate goal is to keep a patient comfortable where they live and avoid emergency room visits and hospitalizations.

3. Patients and their families often choose hospice too late.

Hospice admission is based on a physician, nurse practitioner, or physician assistant determining that a patient has six months or less to live. However, patients can often remain on hospice services if they continue to be eligible.

Depending on a patient’s diagnosis, some patients may be on hospice services for an extended period of time, while other patients seek care in the last days or even hours of life. Nationally, the average length of stay on hospice services is approximately 97 days. The interdisciplinary team model in hospice provides a tremendous amount of support that is often not fully experienced in a short hospice stay. It is often that hospice team members hear, “I wish we had not waited so long.”

4. The goal of hospice care is to provide care in the home.

Hospice is provided wherever a patient calls home – that can be a home, apartment, senior living community, or nursing home. Most hospices aim to keep patients where they are comfortable and bring as many services to them as possible. Although there are “hospice homes” where patients can receive more intensive care, utilization can be time-limited and is reserved for those that require more intensive pain management or symptom control.

5. Hospice collaborates with your doctor and other community providers.

While in hospice, patients do not have to lose their usual medical care or other community providers. In some cases, hospice is intended to enhance, not replace, your longstanding provider relationships. For others, hospice is a total replacement of a prior care team. In both instances, hospice creates a team approach to guide patients and their families through the end-of-life process.

Hospice referrals typically come from community physicians and other providers like Nurse Practitioners and Physician Assistants. Hospice works to collaborate with provider partners like hospitals and nursing homes to emphasize how “just-in-time” hospice referrals do not allow a patient to fully benefit from hospice services.

6. Hospice often provides free services and supplies.

While on hospice care, a hospice provider will assure that patients have all the medical equipment and supplies they need, and oftentimes these supplies are free of charge. This includes oxygen, hospital beds, wheelchairs, and other necessary items. Many hospices also supply incontinence supplies, gloves, and everything else necessary for patients to be comfortable in their own home.

It is clear that hospice care offers crucial benefits to patients at any end-of-life stage. If those in the deathcare industry can continue spreading the word, and ensure families and patients are educated and informed, more people will be able to benefit from this special type of care.