What is Hospice?
Hospice is a service that provides medical, spiritual, and social work services to individuals and families when a doctor has declared an individual to be within six months of death. The medical team evaluates the patient and talks with the physician; the social worker talks to the patient and to the family about the issues that situation creates for them. If the family wishes, a spiritual care coordinator or pastor meets with them to provide counseling. After the hospice admission is completed, the team including attending physician, nurse, social worker, and spiritual care coordinator develop a care plan. The nurse will meet with the patient and family at least once per week. The nurse and other disciplines will increase visits as the patient declines. An aide or volunteer also may be assigned to assist with bathing or personal care. Read more about hospice at the Hospice Foundation of America.
Access to Hospice
When my physician or medical team say it is time to explore hospice services, how do I know if I’m ready?
I need to have stopped curative care. I need to be willing to no longer receive chemo/radiation, transfusions, dialysis or any specialty/curative care related to my terminal condition. I can learn more about hospice and request a hospice evaluation through:
- My physician
- The hospital/clinic social worker
- Family
- Friends
- Myself
Note: Anyone can refer themselves to hospice by simply contacting a hospice agency and requesting an evaluation.
Who Pays for Hospice?
- Medicare – Anyone who has base Medicare (Part A) will have their hospice services fully covered under Medicare. There are no supplemental plans needed to have hospice services covered under Medicare. However, you may still wish to keep a prescription drug plan as hospice may not be able to cover all medications, this would be discussed with you on admission. Read more at medicare.gov.
- Medicaid – Anyone who has Medicaid at any level will also have their hospice services fully covered. The hospice social worker may assist you in applying for Long Term Care Medicaid to pay for caregivers or facility placement.
- Private Insurance – You need to determine the fullest benefits available with your type of health insurance. However, the large majority of private insurance plans will cover hospice care for at least 6 months. You will be assessed by your hospice team continuously and they will submit a claim for additional coverage if you still require hospice services after 6 months.
- If you have no insurance at all, you can still receive hospice services. You will not be disqualified from hospice services due to an inability to pay. The hospice social worker can assist you to apply for Medicaid or Charity Care
Choosing a Hospice
Here are some questions for finding the hospice that is right for you:
- Hospice Organization – When and who founded this hospice? What is their philosophy of care? Is there a religious orientation? Is the hospice “for profit” or “not for profit”?
- Services – How do I determine their strongest and weakest services? Is training available for the family caregiver when I become a hospice patient? Who can best help my family deal with my impending death? Who can comfort me and my family when I no longer can? Who helps cover medication, equipment, and supply costs?
- Help with Problem-Solving – How does hospice help families cope with changing fears and make decisions about services needed as death approaches? When is my right to make decisions transferred to another?
- Availability – Is nursing coverage available during evening/night and weekend hours? How big an area does hospice’s after-hours nurse cover? Is there back-up coverage if the nurse is busy with another family? What happens if I run out of pain medication?
- Staff Organization – Who is the medical director and how long has the director been there? How often do the medical director and hospice team review my plan of care? Who interacts with my physician, and what happens when my physician cannot be reached?
- Volunteers – If I need a volunteer to stay with me or help with errands, how is that match made? What training do volunteers have? If an issue comes up between my family and a volunteer, who helps resolve it?
- Social Worker Involvement – In addition to helping with financial concerns or applications, what other resources can they help with? Will they assist in talking to out-of-town family members?
- Spiritual Care Coordinator – Is this usually a chaplain? If I have my own minister, how are services coordinated?
- Bereavement Services after Death – What services are offered to my family after my death and for how long? Will hospice contact my family or must family members request this service?
- Services and Burial – Does the hospice staff have information offered by the Funeral Consumers Alliance of the Virginia Blue Ridge concerning final arrangements and alternatives to traditional choices?
- Hospice contact information – Check with your physician, a hospital social worker, or internet listings, to find the hospices in your area.
