Hospice FAQs

• Hospice is appropriate for those with a terminal illness when the goal of treatment begins to shift from curative interventions to quality of life.  This time may come well before a physician indicates that the patient’s life expectancy is likely six months or less.  Sadly, many people (and physicians) wait until the final days of life to involve hospice.
• By contacting hospice earlier, patients and families have time to better understand their options and choose the path that will have the most positive impact on their quality of life.  A patient may change his or her mind at any time and can pursue other care options for any reason with notice to the hospice provider.

• The answer is yes, within limits. Hospice guidelines state only one physician can be paid by Medicare/Insurance for medical care related to the hospice diagnosis. However, all other providers can be paid for medical care not related to the hospice diagnosis. This also means your PCP can serve as your Hospice Provider.

• When you begin hospice care, medications, and other treatments intended to cure or control your serious illness will no longer be covered by your insurance or Medicare plan. For example, if you are receiving chemotherapy that is meant to treat or cure your cancer, that must be stopped before you can enter hospice care. However, a person in hospice can continue to take medications to treat other conditions or symptoms, for example, high blood pressure or diabetes.

• Your hospice team will collaborate with you and your loved ones regarding your wishes and the plan of care. While hospice MAY recommend certain medications to manage symptoms, they are not required.

• Hospice care provides compassionate care for people in the last phases of life-limiting illness so that they may live as fully and comfortably as possible. Hospice philosophy accepts death as the final stage of life: it affirms life, but does not try to hasten or postpone death.

• Hospice regulations require that a registered nurse (RN) make an on-site visit to the patient’s residence at least once every 14 days to assess the patient, evaluate the efficacy of any medications or interventions, and communicate with the Interdisciplinary Group for any needed changes to the plan of care. Every 14 days, the RN will also assess the performance and services provided by the hospice aide to ensure they are still meeting the needs of the patient.
• The professional standard of Hospice in the Desert is that a RN will make an on-site visit twice weekly unless the client declines the visit. When the patient is nearer to dying, either the RN and/or social worker will visit more frequently and possibly daily.

• Hospice aides will see the patient anywhere from 1-3X/weekly or biweekly as established by the care plan. There is no set standard for the number of visits. The patient has the right to refuse visits but if multiple visits are refused the aide may be reassigned.

• Certainly! Most hospice care occurs in a patient’s home even if that patient lives alone. Hospice will work with the patient to identify caregivers for when the time comes in which additional care is needed. You may also receive hospice care in a skilled nursing facility, assisted living facility, or adult care home.

• Hospice care is covered by most insurance carriers including Medicare, Medicaid, and private insurers. The hospice receives payment from your insurance carrier, for a fixed daily rate which varies slightly by geographical location and from insurer to insurer.
• If you do not have health insurance, you still will be eligible for hospice care, often at no or very little cost to you and your family. You should check with the hospice provider you select about any additional costs for care not covered by insurance.

• When someone enters hospice care, they are asked to pick someone to be their primary caregiver even if that person is not needed yet. Usually this is a family member or close friend. The primary caregiver works with the hospice team and patient to develop a care plan based on the patient’s specific needs and preferences.

Advance directives are documents written in advance of a serious illness that state your choices about medical treatment or name someone to make choices about medical treatment for you, if you become unable to make decisions. Generally, you have the right to refuse any medical or surgical treatment you do not wish to receive. An advance directive helps ensure that your wishes are followed. It also helps alleviate the burden of decision making for your loved ones because your wishes have already been stated.

No.  A severe illness or serious accident can happen to a person at any age. If you have strong feelings about what choices you would want made in such a situation, you are encouraged to consider signing an advance directive.