Choosing Hospice

Carol R. Anderson, RN, BSN is the Director of Quality Improvement & Staff Development at Long Term Solutions. She frequently writes information for our Provider Knowledge Center, a resource for our field clinicians. Here is a post she wrote about hospice care.

"In our careers, most of us have cared for someone who is terminally ill and facing his/her end of life. With the exception of accidents and homicides, dying is a process. It is a journey. Many things affect how the dying and their loved ones work through this process: culture, age, religion, family position, the illness itself, and formal and informal support systems are just some of them. There are many considerations, all of which need to be addressed.

Presenting hospice as an alternative can be difficult, depending on the disposition of the client and their loved ones. One way to think of hospice is as an alternative to traditional care. Hospice is appropriate for the clients who wants to spend his or her final time at home, with the goal of the hospice care being improving the quality of this time with comfort and dignity. It can be provided to a client in a wide variety of settings. It could be in their private home and in a facility, and many hospitals have hospice beds.

Hospice care is provided by specially trained teams. Hospice teams are multidisciplinary with a variety of trained professionals able to provide a unique type of care. They plan the care to address the bio-psychosocial needs of the client and family. Not only will the team address the symptoms of the disease, with focused attention on pain, but they will help to guide the client and family through the social, emotional and spiritual impact of the end of life process.

Understanding Hospice -- Facts and Fiction

Fiction: People are typically referred to Hospice when life expectancy is six months or less. 

This is not to say that this is always the case, but a client can remain on hospice for longer than six months with physician certification.

Fact: A client can choose to decline or discontinue hospice at any time, or they can change hospice agencies if the hospice team doesn't feel like the right fit for the family.

Fact: Life is not prolonged with hospice care, and it is not hastened.

Fact: Bereavement and counseling services are available before and after the client passes.

Fact: Hospice has coverage 24/7, but does not provide 24/7 care. Additional resources may be needed to provide additional client care.

Fact: When Hospice is called in, they connect with the client’s physician and meet with the client and his/her family or loved ones.

Who constitutes the Hospice Team?

As we noted before, the hospice teams are multidisciplinary. A typical hospice team can include physicians, nurses, home health aides, chaplains, social workers, nutritionists, and trained volunteers. If necessary, specialty clinicians can be brought in, such as wound and ostomy nurses, physical therapists and occupational therapists.

Who pays for Hospice?

Hospice is a covered benefit under Medicare, and most states offer hospice under Medicaid or Public Aid. Furthermore, many private insurance companies have hospice benefits"