Although most people prefer to die at home, most deaths occur in hospitals or skilled nursing homes. The 1983 Medicare Hospice Benefit was passed to offer a different philosophy of, and approach to caring for persons near the end of life. Hospice services are offered primarily in home, but also in hospitals, assisted living, and skilled nursing homes.
What services does hospice provide?
Hospice services treat the physical, medical, emotional, and spiritual needs to support the patient and the family. The focus is on reducing pain, controlling symptoms, and restoring personal dignity, and control over the dying process. Quality of life is as important as length of life.
Hospice services are available 24 hours a day, 7 days a week. Hospice services are provided under the direction of a physician and are carried out by a team of health and social service professionals which often include registered nurses, social workers, a chaplain, and trained volunteers. The services the patient and family receive depend on the patient and families’ need. Services may include; management of physical symptoms, pain relief, inpatient care when needed, emotional and spiritual counseling, homemaker services, skilled nursing care, medical equipment, assistance with personal hygiene, respite care for the family, and bereavement counseling for family and friends after the death.
What hospice services does Medicare cover?
For an older adult, Medicare usually covers the cost of hospice and hospice related services. However, there is a copayment of $5 per prescription for pain management prescriptions. To qualify for hospice a physician certifies that the patient has a terminal illness and is expected to live at most six months. The patient must decide not to pursue any treatment intended to cure the illness, and sign a form declaring this intent. Once a patient is on hospice, Medicare does not cover curative treatments. The Medicare Hospice Benefit booklet details the process and benefits in detail.
It is important to determine if the hospice agency will meet the needs of your loved one and family. The following important questions are a good start to finding the hospice that will work for your family.
- When looking for a hospice it is important to ask if they are Medicare certified. If they are not Medicare certified, Medicare will not cover the services.
- Do they have their own staff (and who are these staff) on call 24 hours a day? It is important to determine who will answer your call in case of an emergency that occurs during non-business hours.
- How often will someone from hospice visit your loved one? What types of visits are included? Ask about nurses, social workers, aides, volunteers.
- Will they do their best to be there before, while, and after your loved one passes? This is known as ‘continuous care.’ The Kaweah Delta No One Dies Alone program in Visalia is a good example of a program dedicated to life until the very last breath.
- What role do they expect family members to play? Will there be one designated family caregiver, and what are their roles and responsibilities?
Research has shown hospice can improve the quality of life, and most families appreciate the supportive services. Hospice can provide information to address concerns which helps families make educated decisions. For those interested in considering hospice Medicare covers one free hospice consult. This is probably one of the most important health care decisions to make, asking questions early can help in making the right decision.