Hospicequestions

01

What is hospice care?

Hospice care focuses on the care, comfort and quality of life of a person with a serious illness who is approaching the end of life. At this stage, treatment meant to cure the illness stops and care turns fully to comfort.

A hospice team supports both the patient and the family with medical, emotional and spiritual care.

Source: National Institute on Aging: What Are Palliative Care and Hospice Care? (opens another website)

02

How is hospice different from palliative care?

Palliative care can begin at diagnosis. A person can receive it alongside treatment meant to cure an illness. Hospice care is for people nearing the end of life, after curative treatment has stopped.

For hospice, a doctor believes the person has six months or less to live.

Source: National Institute on Aging: What Are Palliative Care and Hospice Care? (opens another website)

03

Who qualifies for hospice under Medicare?

Medicare covers hospice care when all of these are true:

• You have Medicare Part A (Hospital Insurance).
• Your hospice doctor and your regular doctor, if you have one, certify that you are terminally ill, with a life expectancy of six months or less.
• You accept comfort care (palliative care) instead of care to cure your illness.
• You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.

Source: Medicare.gov: Hospice care coverage (opens another website)

04

Where is hospice care given?

Hospice care can be given at home or wherever a person lives, such as an assisted living facility or a nursing home. It can also be given in a hospital or in a separate inpatient hospice facility.

Source: Medicare.gov: Hospice care coverage (opens another website); National Institute on Aging: What Are Palliative Care and Hospice Care? (opens another website)

05

Who is on the hospice team?

A hospice team usually includes doctors, nurses, hospice aides, social workers, spiritual advisors and trained volunteers. Together they give medical, emotional and spiritual support.

Someone from the team is usually available by phone 24 hours a day, seven days a week.

Source: National Institute on Aging: What Are Palliative Care and Hospice Care? (opens another website)

06

What does a hospice aide do?

A hospice aide gives hands-on personal care, such as bathing, grooming and dressing. Under the federal rules for Medicare hospices, an aide’s duties include personal care, simple procedures that extend nursing or therapy services, help with walking and exercises and help with medications a patient ordinarily takes on their own.

A registered nurse visits at least every 14 days to check the quality of the care the aide provides.

This is the work Peter Rolita has done for more than twenty years. It is the point of view of his book.

Source: Code of Federal Regulations: 42 CFR 418.76, Hospice aide and homemaker services (opens another website)

About the book

07

What does hospice cost with Medicare?

For covered hospice services from a Medicare-approved hospice, you pay nothing. You pay a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management. You may pay 5% of the Medicare-approved amount for inpatient respite care, which is short-term care that gives caregivers a rest.

Medicare doesn’t cover room and board, whether you get hospice care in your home or live in a nursing home or a hospice inpatient facility.

Source: Medicare.gov: Hospice care coverage (opens another website)

08

Can you still see your own doctor or get other care?

Yes. You can still see your regular doctor or nurse practitioner if you have chosen them to be the attending medical professional who helps supervise your hospice care.

Original Medicare still pays for covered benefits for any health problems that aren’t part of the terminal illness.

Source: Medicare.gov: Hospice care coverage (opens another website)

09

Does hospice help the family after a death?

Yes. Medicare-certified hospices must make bereavement services available to the family for up to one year after the patient’s death.

Source: Code of Federal Regulations: 42 CFR 418.64(d), Bereavement counseling (opens another website)

10

How do we start talking about end-of-life wishes?

A good first step is talking about what matters most to the person. The Conversation Project, an initiative of the Institute for Healthcare Improvement, offers a free Conversation Starter Guide.

CaringInfo, a program of the National Alliance for Care at Home, offers free guidance on creating an advance directive and on qualifying for hospice care.

Source: The Conversation Project (opens another website); CaringInfo (opens another website)

11

Where can a caregiver find local help?

The Eldercare Locator, a public service of the U.S. Administration for Community Living, connects older adults and their families with local services. Call 1-800-677-1116 or visit eldercare.acl.gov.

Source: Eldercare Locator (opens another website)