The decision to place a loved one in hospice care can be a difficult and emotional one. Having a clear understanding of what hospice care is and how it supports patients nearing the end of life, and their caregivers, can help alleviate some stress for family members.
The primary goal of hospice is to provide comfort and quality of life to patients while addressing the needs of patients, families and caregivers.
Defining Hospice Care
Hospice is defined as supportive care that focuses on comfort and quality of life for patients with a terminal illness. A physician must certify the patient has a life expectancy of six months or less if their disease runs its normal course.
While every case is different, people choose hospice when they are diagnosed with a terminal illness or when they no longer wish to pursue aggressive treatments.
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Hospice is a unique, holistic approach to treating the whole person while addressing the medical, physical, emotional, psychosocial and spiritual needs of the patient and caregiver. These needs are met by an interdisciplinary team of clinicians that include Nurses, Hospice Aides, Social Workers, Chaplains/Spiritual Counselors and Physicians.
Benefits of Hospice Care
People facing a terminal illness may want to spend their final days at home surrounded by family and loved ones as opposed to a hospital or other facility. Hospice care honors that preference by allowing patients to live in the comfort of their own homes. Other benefits of hospice care include:
- Comfort and quality of life
- Pain and symptom management
- Respect for the patient’s goals
- Support for loved ones
- 24/7 accessibility to on-call professionals
- Cost-effectiveness
- Helping prevent avoidable hospital visits
What’s the Difference Between Hospice and Palliative Care?
As you and your family learn more about the right healthcare choices for your loved one, you may have come across the term palliative care in end-of-life care discussions.
While both types of services offer pain and symptom management for those with serious illness, palliative care is provided at any stage of the disease progression and includes curative care treatments. Hospice care is appropriate for patients with a life expectancy of six months or less as certified by a physician.
Hospice Services
Each patient’s hospice care plan is based on their individual needs and what matters most to the patient and caregiver. Some examples of hospice services include:
- Nursing care
- Help with bathing, dressing, and grooming from a hospice aide
- Medications, medical supplies, and equipment related to the hospice diagnosis
- Companionship from a volunteer
- Short-term inpatient care to manage pain and symptoms, if needed
- Respite care if needed
- Dietary counseling
- Bereavement support
Hospice services also support the patient’s family and caregivers. For example, the hospice care team teaches caregivers how to provide day-to-day care. To ease the stress of caregiving, hospice offers respite care to give caregivers a break when needed. Additionally, hospice bereavement counselors help families through the grieving process for 13 months after their loved one has passed.
Four Levels of Hospice Care
All Medicare-certified hospice agencies are required to provide four levels of hospice care. The appropriate level of care is determined by the hospice team based on the patient’s circumstances and the patient’s specific plan of care developed by patient, caregiver and the hospice team.
The four levels of hospice care include:
Routine Home Care
Routine home care is the most common type of hospice care, providing patients a comfortable and familiar environment for their final days wherever they call home. The interdisciplinary hospice team will conduct intermittent visits based on patient and caregiver needs. Hospice team members, including the needs. Hospice physician, nurses, social workers and chaplains, are on call 24/7 to meet any ongoing needs.
The hospice team will determine any equipment or supplies needed to support the patient and caregiver. Hospice will provide equipment or supplies related to the patient’s terminal illness.
Respite Care
Serving as a hospice patient’s caregiver can be very taxing. Respite care is available when caregivers need a break. The patient will be admitted to a long-term care facility or other inpatient facility with 24-hour nursing available for up to five days/five nights to provide respite for the caregiver. The primary hospice team continues to provide care and coordinates the plan of care with the facility. Hospice also can arrange transport for the patient to the facility and back after the respite stay as needed.
Continuous Home Care
Continuous home care offers a more intensive level of medical care for pain or other symptom crises that can be managed in the home. The hospice team provides at least eight hours of continuous nursing care in a 24-hour period. Once the crisis is resolved, the team will transition the patient back to routine home care.
General Inpatient Care
General Inpatient Care (GIP) is appropriate when the patient’s uncontrolled pain or other symptoms cannot be controlled at home. When significant medication adjustments or other stabilizing treatments are necessary, the hospice team will facilitate a transfer to a hospital, long-term care facility or hospice inpatient unit with 24-hour nursing care for GIP. The hospice RN will continue daily visits to assess the patient and continue coordinating the plan of care with the facility staff and Hospice team.
When the patient’s pain and symptoms are better managed, the hospice team will arrange the patient’s transfer home as needed, and the patient will be returned to routine level of care.
Where is Hospice Care Provided?
Research shows that more than half of patients receive hospice care at home; however, hospice care can be received wherever the patient calls home. Hospice care can be provided for patients residing at a nursing home, long-term care facility, hospice center, homeless shelter, or a hospital depending on the level of hospice care needed.
Hospice Care at Home
When patients receive care at home, they are more likely to feel safe, comfortable and surrounded by the people that mean most to them. Their hospice team will make intermittent visits with focus on pain and symptom control, help with tasks such as bathing and dressing, and promote comfort.
Hospice Care in a Nursing Home/Long-Term Care Facility
When receiving hospice in a nursing home, assisted living or skilled nursing facility, the hospice team provides care just as when providing care in the home. The day-to-day patient care activities are performed by facility staff. Some facilities have their own hospice units to care for terminally ill patients.
Skilled nursing care or long-term care facilities are an option for patients without family, friends, or caregivers to provide day-to-day care, or if there are complex needs.
Hospice Center/Facility
Hospice centers allow patients to live in a comfortable home-like environment where they receive short-term hospice care. A hospice center can benefit a patient who needs 24/7 care for a short period of time, who needs pain or symptom management, or who has no caregivers at home.
Hospice Care in the Hospital
The goal of hospice care in a hospital is to get the patient’s symptoms under control so the patient can go back home or to a facility. Additionally, hospital care can help with symptoms that cannot be managed at home or in a home.
Learn more about the ways that hospice can be provided.
Does Insurance Cover Hospice Care?
Medicare and Medicaid cover hospice care, including all four levels. The patient must meet eligibility requirements to be admitted to hospice services. This includes having a diagnosis of a terminal illness with a prognosis of 6 months or less, certified by the physician By electing the Medicare Hospice benefit the patient is electing supportive care over curative treatments. There are additional options for paying for hospice care, including veteran’s benefits, private insurance and more.
Find Hospice Care Near You
If you think hospice may be the answer for your loved one, we offer several resources to guide you on your discovery journey. You can complete our hospice care assessment quiz to help determine eligibility, complete the form below to speak to a hospice specialist or call a location near you.
