Understanding Hospice Part 2

Lots of great information to better understand this unique service line. Hospice is such a great benefit that is so misunderstood. We will finish out the answers to our Hospice quiz from 2 weeks ago. As always, if there are any questions, please email us at info@elitehhh.com

Hospice provides medications, treatments, medical equipment and supplies that are related to the patient’s illness that is causing the need for services.

Hospice reviews each medication and works with the patient and family to support medications that are providing comfort. Medications that are unrelated to the diagnosis causing the need for hospice may be an out-of-pocket cost for families. This should be reviewed and discussed at the evaluation visit.

Hospice ends when the patient dies.

Grief support is provided for the family members after the patient has passed away for 13 months. Social workers and chaplains often support this service.

Hospice care is available to any individual expected to live 6 months or less.

Patients can live beyond 6 months while on hospice. The health status is regularly reviewed to determine continued eligibility. Hospice services may end due to the patient no longer having a 6-month prognosis. Patients may graduate from hospice at this point. If the patient begins to decline, they can be readmitted to the hospice program again.

People who live alone are able to receive hospice.

Most hospices will enroll a patient without a caregiver. Usually, if there is a concern for caregiver needs, this may become a focus of the hospice care plan to assure the patient has proper care and support as their disease progresses and additional help is required.

Hospice is designed to treat the emotional needs of the dying individual and their family.

The hospice team is uniquely trained to provide emotional support. The unique training of social workers and chaplains aids in meeting these needs. The patient and family determine the level of support provided.

Dementia, such as Alzheimer’s disease, cannot have hospice.

Around 13% of all hospice patients have a diagnosis of one of the dementias. This is becoming the largest and fastest growing segment of hospice.

While on hospice, individuals can receive treatment such as chemotherapy, radiation, or surgery to cure the illness causing the need for services.

In many cases, these interventions are considered curative. As such, the role of hospice cannot properly be provided, and patients will often choose to discharge from hospice in pursuit of these services.

Individuals on hospice cannot be taken to the hospital.

Hospitalization is usually unnecessary while on hospice. Unrelated conditions may be treated in a hospital setting while on hospice. The important thing is to let the hospice agency know, so they can properly advise if a hospitalization is the best treatment plan based on overall goals. The hospital will also need to be informed to support the patient’s decisions for care.

Hospice care focuses on managing pain and symptoms.

The purpose of hospice is quality pain and symptom management. In fact, this is one of the key metrics that contributes to a hospice’s rating. Most patients expect hospice to address pain relief as a priority in the care plan.

Hospice is for the caregivers, family, and friends, as well as, the patient.

Hospice is a team targeting physical, emotional, psychosocial, and spiritual needs. Additional members that may be available, depending on the hospice, include massage therapists, physical therapists, occupational therapists, speech-language pathologists, pharmacists, and volunteers.

Hospice is a minimum of 12 hours of daily bedside care provided by the clinicians.

Hospice is generally provided as visits by different team members each week. The frequency and duration of visits will depend on the patient’s needs. There may be a need to supplement services with hired caregivers to meet all the needs of the patient.

Understanding Hospice

Last week, we gave a 24-question quiz to test your knowledge of hospice. What we have found is that there are many misconceptions of hospice, what it is, what it is designed to do, and when to pursue it. So, let’s dig into the questions together. As always, feel free to send follow-up questions to info@elitehhh.com

Hospice is a 24/7 service.

Hospice is provided on a 24/7 basis. That means patients and families on hospice can call at any time of day to speak with a nurse or have the nurse come out to the home to do a visit. Our goal is comfort. These issues do not always occur during a regular business day. That is why these are services designed to meet your needs…whenever that may happen.

Hospice is only for 6 months even if you continue to live beyond that time frame.

Hospice is a service designed to be initiated during the last 6 months of life. BUT, this is not an exact science, and patients are not beholden to the 6 months. Medicare guidelines dictate that hospice services are only to be stopped if the patient’s condition improves beyond a brief or temporary period that the life expectancy is now beyond 6 months. Hospice benefits do not expire, and patients can access these benefits if conditions change again, and they now qualify for hospice again.

Hospice is only for cancer patients.

Hospice is not contingent on a particular disease process, like cancer. In fact, many hospice patients have conditions related to heart and lung disease, dementia, kidney failure, neurological disease, and many other conditions. Hospice is not a cancer-specific service.

Hospice services are paid for by health insurance.

Hospice is covered by nearly all insurance plans. Medicare and Medicaid cover these services in nearly all 50 states. Coverage may vary state by state. Some things are not covered based on state benefits such as nutritional supplements and disposable supplies. Room and board at a nursing home and over the counter medications are typically not covered and are often paid out of pocket by the family or through a long-term care insurance plan.

Hospice services include comfort and grief support for families after the patient dies.

Hospice includes bereavement services. These services are provided for 13 months after the passing of a loved one. This may be one-on-one counseling, group sessions, or periodic phone calls. Bereavement is often extended to members of the public who interacted with the individual who passed as well.

Hospice can be provided in nursing homes.

Hospice can be provided in a residential setting. That means traditional homes/apartments/condominiums, nursing homes, and assisted living communities – including memory care facilities may all serve as locations for hospice.

Hospice is only appropriate if the person only has a few days to live.

Hospice is designed to be a gradual progression of increased care and support as symptoms change and the body changes. Most people find hospice is beneficial when the full range of skilled medical, emotional, and spiritual support services for provided for at least a month or longer.

Patients on hospice cannot receive care from spouses, partners, children or other loved ones.

Hospice supports the family and caregivers of the patient through education and partnership. Support for stress and identifying resources are often key elements of the hospice care plan. In most cases, family members provide the day-to-day patient care.

Hospice helps by speeding up the dying process.

Hospice does not speed up the dying process. At this point of the illness, no medical intervention can prolong or cure the terminal illness. Hospice is designed to support the quality of life by addressing symptoms and discomfort. Some studies suggest patients actually live longer on hospice than without the service.

Hospice cannot be provided in the home.

Over 66% of all hospice is provided in the home setting!

Only persons older than 65 can receive hospice.

Hospice is not constrained to age. Any person with a terminal diagnosis and expected to pass in 6 months is eligible for hospice, regardless of age.

Anyone can make a referral to hospice.

Anyone can initiate the process for a hospice review. Often, patients, family members, or caregivers reach out to hospice and ask if the service is appropriate. This usually starts a conversation with the patient’s provider (doctor, nurse practitioner, or physician assistant) to better understand the patient’s prognosis and goals. If hospice makes sense, the provider writes an order, and the hospice assessment occurs.

Lots of great information here. If there are questions, let us know. We are happy to answer any questions you may have. Email us at info@elitehhh.com

Hospice Quiz

November is National Hospice and Palliative Care Month!

Let’s test our knowledge and learn together!

True or False:

  1. Hospice is a 24/7 service.
  2. Hospice is only for 6 months even if you continue to live beyond that time frame.
  3. Hospice is only for cancer patients.
  4. Hospice services are paid for by health insurance.
  5. Hospice services include comfort and grief support for families after the patient dies.
  6. Hospice can be provided in nursing homes.
  7. Hospice is only appropriate if the person only has a few days to live.
  8. Patients on hospice cannot receive care from spouses, partners, children or other loved ones.
  9. Hospice helps by speeding up the dying process.
  10. Hospice cannot be provided in the home.
  11. Only persons older than 65 can receive hospice.
  12. Anyone can make a referral to hospice.
  13. Hospice provides medications, treatments, medical equipment and supplies that are related to the patient’s illness that is causing the need for services.
  14. Hospice ends when the patient dies.
  15. Hospice care is available to any individual expected to live 6 months or less.
  16. People who live alone are able to receive hospice.
  17. Hospice is designed to treat the emotional needs of the dying individual and their family.
  18. Dementia, such as Alzheimer’s disease, cannot have hospice.
  19. While on hospice, individuals can receive treatment such as chemotherapy, radiation, or surgery to cure the illness causing the need for services.
  20. Individuals on hospice cannot be taken to the hospital.
  21. Hospice care focuses on managing pain and symptoms.
  22. Hospice is for the caregivers, family, and friends, as well as, the patient.
  23. The Hospice team is a physician, nurses, social workers, and chaplains.
  24. Hospice is a minimum of 12 hours of daily bedside care provided by the clinicians.

Here are the answers:

  1. True
  2. False
  3. False
  4. True
  5. True
  6. True
  7. False
  8. False
  9. False
  10. False
  11. False
  12. True
  13. True
  14. False
  15. True
  16. True
  17. True
  18. False
  19. False
  20. False
  21. True
  22. True
  23. True
  24. False

Explanations will be in next week’s blog…stay tuned!