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Exploring the Compassionate World of Hospice Care

“You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully but also to live until you die.”

Dame Cicely Saunders
Founder of Modern Hospice

Hospice is a vital part of healthcare with this compassion-driven type of care focusing on end-of-life care versus curing and prolonging life. Their end-of-life care includes emphasis on personalized care plans, managing symptoms and pain, improving quality of life, assisting with emotional, psychosocial, and spiritual aspects of death, providing supplies and equipment, helping teach families how to care/interact with the patient, and delivering special services including physical therapy or music and art therapy.

Did You Know?

Stats/Facts gathered by NHPCO, CDC, Forbes, and Home, Health & Hospice Study

  • There are currently over 1.6 million Medicare beneficiaries enrolled in hospice care.
  • On average, patients remain in hospice for 92.6 days. Though they can access hospice care up to 6 months prior to projected death.
  • Hospice is the least expensive health care environment with an average cost of $190/day for routine home care.
  • The five most common diagnoses for patients in hospice care are:
    Dementia (including Alzheimer’s & Parkinson’s), Respiratory Illness, Circulatory/Heart Illness, Stroke, and Cancer.
  • The American hospice industry is estimated to reach $64.7 billion in revenue by 2030.
Nurse standing next to patient with her hand on his shoulder ha is pointing and both of them are smiling

Navigating Hospice Care

Hospice care is incredibly patient-focused, meaning services and who is on their care team will vary based on their needs or end-of-life plans. Care teams can include:

  • Hospice medical director
  • Home health aides
  • Hospice physician
  • Nurses
  • Social workers
  • Speech, physical, or occupational therapist
  • Pharmacist
  • Clergy or other counselors
  • Trained volunteers
  • A patient’s personal physician
  • Spiritual care providers
  • Dietitian

 

While it seems like hospice is reserved for the elderly, hospice care is available to patients of any age, race, religion, or illness who meet the basic requirements that typically follow these eligibility guidelines:

  • Terminal Illness: Prognosis of less than 6 months
  • The patient is delving functional status which is determined by the Palliative Performance Scale (PPS) rating and Dependence in 3 of 5 Activities of Daily Living (ADLs)
  • Extreme alteration in nutritional status: > 10% loss of body weight within 4-6 months
  • The patient has observable and documentation of deterioration in the overall condition in the past 4-6 months. More than 3 hospital or ED visits, Decrease in tolerance to physical activity, Decrease in cognitive ability

 

Hospice care is commonly covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations and in most cases is provided in the patient’s home. Hospice care can also be provided in freestanding hospice centers, nursing homes or other long-term facilities and hospitals depending on each case.

Nurse helping a patient walk

Hospice Care vs Palliative Care

When exploring hospice options, you may come across something called palliative care. Often hospice care and palliative care are used interchangeably as the same type of care. While they are care programs created for individuals with serious illnesses, they are two separate types of care. When researching your options be sure to follow the basic eligibility guidelines for both and follow the chart below to see what the difference is between the two.

Who can be treated?

Hospice

Palliative

Anyone with a serious illness and a projected death date within 6 months
Anyone with a serious illness

Can I receive treatments to cure my illness?

Hospice

Palliative

No, this care is focused on comfort and symptom relief
Yes

Does insurance cover this care?

Hospice

Palliative

Yes, hospice care is covered by most insurance policies
This depends on your benefits and treatment plan

How long will I receive care?

Hospice

Palliative

You can receive up to six months of care, if you surpass this six-month mark, your case will be reevaluated
This depends on the care and treatment you need

Another important factor in choosing a hospice program is choosing one that works for you. Getting to know and understand the program and who you will be working with is a guaranteed way to ensure the most seamless execution of any end-of-life plans.

When deciding be sure to ask questions including but not limited to:

  • Does this hospice accept my insurance and what services and treatment will be covered?
  • Is the hospice accredited, and if required, state-licensed?
  • How long has this hospice been serving patients?
  • Will this hospice have the medical equipment I need?
  • What members of the hospice team will I need or meet?
  • Will I always have the same nurse/care aid?
  • Does the hospice have help during all hours or a 24/7 contact line?
  • How long should I expect to wait for a response during urgent matters?
  • Do they have the resources to manage my pain and symptoms?
  • What is the best way to communicate?
  • How involved are I or my family in decision-making?
  • How will the hospice prepare me and my family?
  • What support services do they offer?
  • How will the hospice team coordinate and communicate with my doctor?
  • Does this hospice have bereavement services?

Keep It Personal

Choosing a hospice is as personal as the care hospice offers. Ensuring you are surrounded by a care team who are on the same page as you or a loved one when it comes to end-of-life plans is crucial in ensuring all medical or personal needs or wants are met. Remember to ask questions, address concerns, and be clear about all end-of-life plans.
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