Hospice Care

To be admitted to the hospice program, a patient must meet the criteria noted on the Eligibility Guidelines. In general, any patient who is diagnosed with a having a limited life expectancy is eligible. All U.S. citizens age 65 and older are entitled to Medicare coverage for the hospice benefit if clinically eligible. 

To give our team the best opportunity to establish rapport and intervene effectively, we recommend referring to the patient as soon as possible after the patient/family has been informed of the prognosis.

Medicare, Medicaid, Medi-Cal and most major private insurance providers pay for hospice care. If a patient does not have any payment support from insurance, then he or she may pay all or part of the bill personally. The important thing to remember is that no one is denied service because of an inability to pay.

You have the RIGHT to choose your own hospice provider, and that right to choose is protected by federal law.

Yes. In addition to serving you in the home, hospice can provide services wherever you live.

Anyone — including the patient, family member or physician — may make the initial request for service by calling (800) 651-5506. The admissions RN will visit the patient, usually the same day. The patient’s vital information is recorded and, if necessary, the patient’s physician will be contacted for orders and permission to admit the patient to the hospice program.

An initial visit where the patient’s condition and needs are assessed is usually made within 24 hours of the referral. In addition, the registered nurse (RN) will explain hospice services in more detail, explain the role of the other team members who will be visiting, and answer any questions the patient or family may have. If needed, this meeting can happen the same day as the initial visit.

The hospice benefit covers all medications related to the hospice diagnosis. When you are admitted to hospice care, there will be a reason, or a diagnosis, for why you are eligible for care. If medications are related to the pain and symptom management of that diagnosis, hospice will cover the cost of those medications.

The patient and family should feel free to discuss hospice care with their physician at any time. If the patient is an appropriate candidate for hospice care, the patient’s physician may choose to follow the patient and remain actively involved in the plan of care. 

Absolutely! If a patient‘s condition improves and the disease seems to be in remission, the patient will be discharged from service, free to resume aggressive therapy and return to their daily life. If the patient’s condition later changes, Medicare, as well as most insurance providers, will allow additional coverage for this purpose.

Choosing hospice care doesn’t mean giving up hope. It means you are opting for comfort and symptom management, thereby allowing you to regain control of your life.

Hospice is a choice. Patients may choose to discontinue service at any time.

Patients can receive care indefinitely as long as their condition remains appropriate for hospice care. 

Your case manager will work with you upon admission to assess your needs and help with obtaining any necessary medical equipment. Your needs will be reassessed throughout the continuum of care. 

Coordinated patient care is composed of a variety of disciplines working together with the family to provide care in the home, or wherever the patient calls home. The team includes, but is not limited to, the following disciplines:

• The medical director serves as consultant to staff and referring physicians, attends team meetings and oversees the medical aspects of the hospice program.
• The registered nurse (RN) is the team leader and performs the initial assessment. The RN monitors the patient’s condition, reporting changes and problems to the physician. After the initial assessment, a licensed vocational nurse (LVN) may perform many of the same tasks as the RN.
• The medical social worker (MSW) provides psychosocial support for the patient, the family and the hospice staff. The MSW also assists with community referrals and financial concerns.
• The home health aide provides personal care of the patient, such as bathing, shampooing the hair or changing the linens.
• Chaplains are an important part of the hospice team and provide emotional and spiritual care support for the patients and their families. Chaplains, along with the bereavement team, can be an excellent resource for helping with funeral planning or a DVD life tribute.
• Hospice volunteers help patients and families, just as a friend might, by assisting with household tasks, running errands, telephoning or visiting. They are a Medicare-mandated member of the team and invaluable to the care of each and every hospice patient.

No, hospice originally dates back to medieval times when it was a place for weary travelers to find shelter and temporary respite. The word “hospice” comes from the Latin words “hospes” meaning host and “hospitium” meaning hospitality. Today, hospice is recognized as a program of palliative (comfort rather than curative) care and support designed to meet the unique needs of patients and families facing limited life expectancy. Services are provided through a medically directed team of professionals. 

1. Have you or a loved one’s treatments stopped working?
2. Have you or a loved one had multiple hospitalizations or trips to the emergency room in the past six months?
3. Do you or a loved one take pain medication?
4. Have you or a loved one had multiple falls within the last six months?
5. Do you or a loved one have difficulty swallowing, or need assistance with bathing, dressing, walking or getting out of bed?
6. Have you or a loved one been told there are no further treatment options available or has your physician said your condition is life limiting?
7. Are you losing weight?
8. Do you or a loved one need caregiver support to help care for a loved one?
9. Is there any expectation for a meaningful recovery for you or a loved one?

Remember, choosing hospice does not mean you are “giving up.” On the contrary, there is so much more that can be done! We’re here to help improve the quality of your life so that you can get on about the business of living. 

Expectations Within Time Frame  

One to Three Months

• Withdrawal from the world and people
• Decreased food intake
• Increase in sleep
• Going inside of self
• Less communication

One to Two Weeks

• Disorientation Physical
• Agitation
• Confusion
• Talking with the unseen
• Picking at clothes
• Physical
• Decreased blood pressure
• Color changes, pale, bluish
• Respiration irregularities
• Sleeping but responding
• Not eating, taking little fluids
• Pulse increase or decrease
• Increased perspiration
• Congestion
• Complaints of body tired and heavy
• Body temperature to be hot/cold

Days or Hours

• Intensification of One to Two Weeks signs
• Surge of energy
• Decrease in blood pressure
• Eyes glossy, tearing, half open
• Irregular breathing, stop/start
• Restlessness or no activity
• Purplish knees, feet, hands, blotchy
• Pulse weak and hard to find
• Decreased urine output
• May wet or stool the bed

Minutes

• • “Fish out of water” breathing
  • Cannot be awakened