Hospice FAQS & Resources

/Home/Hospice and Alzheimer's/Hospice Overviews and Resources

What Is Hospice, Choosing & Finding A Hospice,
Medicaid/Medicare Coverage, Children, Considerations, Q&A's and Links


WHAT IS HOSPICE?

What is Palliative Care? - A New York Times article addresses a range of problems, from intense pain to depression, that dying people and their loved ones may suffer.

Understanding Palliative Care - A 2 page document from Partnership For Care in PDF format

The Hospice Concept - Hospice emphasizes palliative rather than curative treatment; quality rather than quantity of life. The dying are comforted. Professional medical care is given, and sophisticated symptom relief provided. The patient and family are both included in the care plan and emotional, spiritual and practical support is given based on the patients wishes and familys needs. Trained volunteers can offer respite care for family members as well as meaningful support to the patient.

A Brief Overview of Services-Hospice The Comfort Team-Hospice is really a bundle of services. It organizes a team of people to help patients and their families, most often in the patient's home but also in hospice residences, nursing homes, and hospitals..........

The Hospice Team - typically includes a physician, a nurse, a home health aide, a social worker, a chaplain and a volunteer.

Hospice-A Model for Caregiving - The partnership formed between a family and hospice personnel can ensure quality care for a person who is dying. Hospice support­ive services are designed to offer information and back-up to fami­ly members so that they will be more able to care for their loved one. Hospice care focuses on addressing some central goals

therapy page - Hospices must also provide occupational therapists, physical therapists, and/or speech-language therapists if your loved one would benefit from these types of therapy. You have the right to request these services and to receive these services.

Test Your Hospice IQ - Do you know enough about hospice to be sure that you can help a family member or friend who is seriously ill and nearing the end of life? Take this Partnership For Caring quiz by answering each of the questions "yes" or "no." When you've completed the quiz, see the table to check your score and your hospice smarts!

Complaint Form: Printable - If you have Hospice care and have reason to file a complaint against that Hospice, this is the form to use.

Complaints: Filing (About Improper Hospice Services) Information on the types of complaints you might have and what action to take.


CHOOSING AND FINDING A HOSPICE

When To Choose A Hospice
Although many referrals are made by physicians, anyone can refer a patient to hospice--friend, family member, or clergy. Hospice will contact the physician to see if the patient is appropriate for hospice care. Hospice will then consult the patient and family to see if hospice services are desired. Admission criteria

Find a Local Hospice - Select a state you are interested in or type a provider name and then click search. The search will display a list of cities and counties in the specified state that are served by hospices. Selecting a city or county will result in a list of local Hospice's in the surrounding area that serve that city or county complete with contact information. Or you can look in one of the following:

* National Hospice and Palliative Care Organization maintains a database of hospices for each state in the United States.
* United Kingdom Directory is the most comprehensive list of hospices in the United Kingdom and Ireland
* International Hospice Web has a short list of hospices around the world.


Guidelines For Determining Prognosis/Hospice Coverage -
AHS Medicare ~ Medical Review & Appeals Shows the AMA description of all Hospice Policies for determining needs of care/prognosis. Your physician will review these parameters to help determine whether a patient is appropriate for hospice care and/or for the Medicare/Medicaid Hospice Benefit. These General Guidelines apply to all patients referred to hospice. However, they may be specifically applied to patients who do not fall under any of the specific diagnostic categories for which disease-specific Guidelines have been written.

Worksheets for Determining Prognosis-Hospice - The National Hospice and Palliative Care Organization supports the following guidelines to aid in determining prognosis in non-cancer disease. These worksheets are just a starting point in decision making in non-cancer disease. At the time of admission, clinical judgment must always be applied in each individual case to supplement these guidelines. All documents are in PDF format.

* Adult Failure to Thrive Syndrome
Measurement of weight, nuitrition, daily activity to determine Hospice eligibility
* Debility, Unspecified
Medicare considers Debility, unspecified an appropriate diagnosis for hospice patients when a current weight is unobtainable to obtain a body mass index. When body mass index is not met, Debility, unspecified may be used for patients who meet the general hospice criteria (physician form to determine debility)
* Amyotrophic Lateral Sclerosis
* Dementia/Alzheimer's Disease
* Heart Disease
* All Other Diagnoses

Consumers Guide To Selecting A Hospice - This brochure will help you learn more about hospice care so you and your loved ones can make an educated decision about end-of-life care. It contains information on what hospice care is, what services are provided, and what are the key questions to ask when selecting a hospice program. The brochure will help you choose a hospice program that best suits your needs and wishes, as well as those of your loved ones. Also available in PDF format.


MEDICAID AND MEDICARE HOSPICE COVERAGE

Medicaid Hospice Benefits-Optional By State
Health Care Financing Administration FAQ - In order to be covered, a plan of care must be established before services are provided. The following are covered hospice services: nursing care; medical social services; physicians' services; counseling services; home health aide; medical appliances and supplies, including drugs and biologicals; and physical and occupational therapy. In general, the services must be related to the palliation or management of the patient's terminal illness, symptom control, or to enable the individual to maintain activities of daily living and basic functional skills.

State Medicaid Plans
select a state
The state Medicaid plan section of the CMS web site represents our effort to make the state Medicaid plan materials available to the public in a convenient, searchable format. In order to search a state's plan, please go to above site . You can then search for specific text in the entire state plan, or within selected subsections.

* Descriptions of State Programs


Medicare & Hospice
Hospice is both physical and counseling care provided for people who are terminally ill. Hospice is given by a public agency or private company approved by Medicare. It is for all age groups, including children, adults and the elderly during their final stages of life.

* Eligibility
* Length of Care
* What is Covered?
* Respite Care
* Physician Certification

Medicare Hospice Benefit
Written by Hospice-The Medicare Hospice benefit is entirely different from the Medicare Home Health benefit. The Medicare Hospice Benefit is reimbursed under a system of prospective payment and is subject to its own unique Medicare Conditions of Participation. The Medicare Hospice Benefit is a Medicare Part A Benefit. It is available to Medicare Part A recipients who meet the Hospice program's eligibility requirements. (The Hospice Medicaid Benefit, is currently available in 37 states, and is for those who meet the State medical and financial criteria). The Hospice Medicare Benefit is an exclusive benefit elected by the patient or legal representative to provide for all of the necessary palliative care related to the terminal illness.

Medicare Hospice Benefits [PDF}
This 16 page booklet, from the Centers for Medicare and Medicaid Services, explains what Medicare covers for Hospice care. The booklet is in PDF format which requires Adobe Acrobat Reader.

* The hospice program and who is eligible
* Your Medicare hospice program
* Where you can get more help

Prescription Drugs & Products: Please note, where it explains the family will have to cover no more then $5.00 for each prescription drug and other smiliar products that, typically, this co-pay will be picked up by your own health insurance prescription drug coverage or Medicaid.

Respite: Under Medicare you are to pay 5% of the Medicare payment amount for inpatient respite care at a approved Medicare hospital or nurshing home up to 5 days each time you get respite care. Hospice will bill any private health insurance you may have for this 5% or, since Medicare approved Hospices are non-profit organizations they typically will not bill you for this service if you are unable to pay.

Period of Hospice Coverage: It is important to note that Medicare is no longer showing the strict "6 month" rule. This booklet explains that Medicare will cover Hospice for two 90-day periods followed by an unlimited number of 60-day periods provided the patients physician recertifies that you are terminally ill and your care needs to continue through another period of care.


CHILDREN

Improving End-of-Life Care for Children - A 4 page document from Partnership For Care in PDF format

Pediatric and End-of-Life Resource Directory: A list of web resources from The Robert Wood Johnson Foundation
Precepts of Palliative Care for Children/Adolescents and Their Families - New guidelines set forth by Last Acts, a national program office of The Robert Wood Johnson

What Do You Tell Children?
What we say about death to our children, or when we say it, will depend on their ages and experiences.

Talking To Children About Death
Most of us, at some point in our lives, will have to make some decisions about how to treat children concerning the death of a loved one, or a friend, or neighbor, or a pet. What guidelines can we use?


CONSIDERATIONS

Choosing How to End
Our last days are an opportunity to learn life's last and most powerful lesson: There is nothing to fear.

Considerations at Terminal Stage
Surviving Caregiving-these are notes from an online interview conducted with Stephanie Zeman. Hospice offers services to victims and caregivers that help them through the terminal stages of a disease whether the patient is kept at home or placed into a care facility.


FAQS & OTHER SERVICES

A Checklist of Questions To Ask Hospice-Involvement with a hospice service can be a choice that you plan for, or one that comes up suddenly. Regardless, it helps to know the right questions to ask when shopping for hospice care. Included here are some of the most important questions you should ask when interviewing a hospice service. Before you go to an interview, print this list of questions, read over it, and identify the questions that are most important to you and your loved one. Take the sheet along with you, and jot down the answers during the interview.

Answers To Questions
Hospice links to information on their Services, Patients, Caregivers, Bereavement

Care in the Nursing Home
The services of hospice care programs are provided wherever patients are spending their final days, whether in their own home, in a family member's home or in a nursing home. The hospice team helps patients live out their final days with dignity and with as much physical comfort as possible. The members of the hospice team try to help nursing home patients to be as free of pain as possible.

HOSPICE HOUSES
While most hospice patients are cared for in their homes, Hospice also provides care to
patients at their inpatient facility, Hospice House in larger cities.Hospice House is specifically designed to provide care to patients who have symptoms that require a supervised setting or respite for the care giver.You'll need to check with your local Hospice to determine if they have a Hospice House or similar service in your area. To see an example of a Hospice House, click on http://www.hospice-swf.org/houses.html

Improving Care for the Dying: The Role of Palliative Care in Nursing Homes - Questions to ask.

Debunking The Myths of Hospice in PDF format. Common myths or wrong assumptions make about Hospice, Hospice Care
Frequently Asked Questions (FAQS) About Hospice can help you decide if and when hospice care may be appropriate.

Frequently Asked Questions
Hospice Palm Beach list of FAQS
Who should be admitted to a Hospice program?
What is Hospice care?
When is the right time to call Hospice?
Must a Hospice patient be in acceptance of his/her death?
Who needs to make the call to Hospice to begin services?
Should I wait for our physician to suggest Hospice, or should I bring it up first?
Are all Hospices the same?
Does Hospice do anything to shorten or lengthen a patient's life?
Who provides Hospice care?
Will the Hospice patient's personal physician still be involved in the care?
What does the Hospice admission process involve?
What happens if a patient lives longer than 6 months?
What happens if a patient's condition improves?
What happens in an emergency?
Are there different levels of Hospice care?
Does Hospice of Palm Beach County provide 24-hour nursing care in the home?
Can someone who lives alone receive Hospice care?
What specific assistance does Hospice provide home-based patients?
How long can patients stay in a Hospice inpatient unit?
How much does Hospice care cost and is it covered by insurance?
How often will the Hospice team members visit?
Why would patients choose Hospice care?
Do I have to give up hope?
Is hospice care just for patients with cancer?

FAQS
From the Livingstone Memorial Health Hospice FAQS
Are all hospices the same?
Are we eligible?
Can residents of nursing homes have hospice services?
Does hospice pay for the room and board in a nursing facility?
Does hospice take individuals who have dementia or Alzheimer's disease?
Does insurance pay for hospice care?
How do I get hospice services for a family member who lives in a facility?
I'm not religious, how can a chaplain help me?
My clergy visits often. Why would I need a hospice chaplain, too?
What about the family?
What does hospice do that is different from what the staff in the facilities do?
What is spiritual support?
What services are included?
What to Expect?
What's the difference between religion and spirituality?
Who comes to help?
Why Me? What Now?
Will the chaplain try to make us religious?

Guidelines for Patient/Family Volunteers

What Questions Should I Ask?
There are a number of questions you might ask when deciding on a hospice program. Accreditation, Certification, Licenser, Consumer Information, References, Admissions, Plan of Care, Family Caregivers, Preliminary Evaluation, Personnel, Costs....and more. Read about them on this Hospice site.


HOSPICE LINKS

American Cancer Society: Spend a few minutes exploring this site and you will find a wealth of excellent information on a wide variety of topics.

OncoLink is one of the most respected and comprehensive locations for information on all aspects of cancer. The site is operated by the University of Pennsylvania Cancer Center.

Palliative Care Associations Worldwide-IAHPC's International Directory of Palliative Care Associations by country

Partnership for Caring advocates the rights of individuals to participate fully in decisions regarding their medical treatment at the end of life. Information is provided regarding the preparation and use of advanced directives on a state by state basis.

Pain.com contains over 1700 articles on pain management, a searchable database of pain specialists and pain clinics in the United States, and links to related resources on the Internet.