While most people have heard the term hospice before, there can be confusion about what hospice care really is and what it isn’t. Suzanne Karefa-Johnson, MD, a hospice physician at Florida Hospital, provides information and insight about what hospice can do for patients at the end of their lives.
What is hospice? What isn't hospice?
Hospice isn’t a place, but rather is a way of caring that brings comfort to people with a life-limiting illness. The focus is on enhancing a patient’s quality of life. Each patient and his or her caregivers receive individualized care that meets their unique physical, emotional and spiritual needs. Hospice care focuses on caring, not curing, and neither hastens nor prolongs the dying process.
“Hospice is truly the best model for delivering end-of-life care,” says Dr. Karefa-Johnson. “The goal is to seamlessly integrate life, dying and the process for family members after a loved one has died.”
Does hospice mean you have to go to the hospital, a nursing home or a special center? Or, can my loved one receive in home hospice care in his/her own bed?
Because hospice is a way of delivering care at the end of life, it goes to where the patient is.
“Most patients in hospice are at home, but some are in nursing homes, assisted living, or the hospital,” explains Dr. Karefa-Johnson. “It’s not about where the patient is, it’s about what they need. Some hospice organizations do have brick and mortar facilities, but hospice care is not tied to a location.”
Who makes up the hospice medical team?
The interdisciplinary hospice team includes a physician, nurse, social worker, non-denominational chaplain, certified nursing assistant, trained volunteer and bereavement counselor.
“The hospice team meets with the patient and family to create an integrated care plan to address each patient’s unique needs. Each member of the team works to provide the patient and family with the care and support they need,” Dr. Karefa-Johnson says.
Is hospice only for elderly patients?
“No, although many people have that perception,” says Dr. Karefa-Johnson. “Hospice is there for patients of any age dealing with a terminal disease. Medicare hospice benefits can be activated when two physicians certify that a patient has six months or less to live.”
Does hospice assist the family after the patient dies?
Yes, hospice provides continuous support for 13 months following the death of a loved one with individual counseling, grief support groups, workshops, social groups and literature.
Is hospice covered by medical insurance, Medicare or Medicaid?
Hospice services are covered under Medicare Part A, Medicaid and most private insurances. This benefit covers the hospice team’s services, medications, supplies and equipment related to the patient’s life-limiting illness. There may be co-pays, co-insurance or a deductible under insurance plans. Hospice staff will work with patients, families, insurance providers and other resources to ensure the patient receives all the benefits available.
What criteria should I consider if there's more than one hospice program available?
You should be sure that any hospice program is Medicare certified. Medicare requires certified hospices to provide minimum requirements of care, but the quality and quantity of services may vary greatly.
“Talk to your family, friends and physician for hospice recommendations,” suggests Dr. Karefa-Johnson. “Also ask about the credentials and training of the hospice staff, as well as any extra services, such as pet therapy or aromatherapy, as these can vary from hospice to hospice. The goal should be to find the hospice program that is right for you and will address what is important to you.”
When is it time for hospice?
Many patients and families consider hospice care when there is an incurable disease with a life-limiting prognosis and curative treatment is no longer available or desired.
“I recommend that families have ‘courageous conversations’ about end-of-life planning before the need becomes imminent,” Dr. Karefa-Johnson says. “And don’t wait to contact hospice once you have a life-limiting prognosis. Everyone we work with always says they wish they had contacted hospice sooner.”