Hospice care is a holistic medical specialty focusing on alleviating symptoms, promoting comfort, and improving the quality of life for both the patient and the family members involved in end-of-life care through medical, emotional, and spiritual guidance.
No, not at all. Hospice redefines hope for each patient and family. Where a patient may have once hoped for a cure, they now hope to live their final months pain-free, surrounded by friends and loved ones. Hope can be as simple as wanting to remain at home rather than making frequent trips to a hospital. Or it can provide opportunities for lost relatives to reconnect, old wounds to heal, and forgiveness to be extended. Hope may look different in hospice care, but it is not lost.
The right time to enter hospice care is unique to each individual, but it is generally appropriate for patients with a terminal illness and six months or less life expectancy. The right time to enter hospice care is unique to each individual, but too often patients are referred to hospice care late in their illness. An earlier referral means more support for both the patient and the family, so we always want families to consider hospice as a health care option after receiving a terminal diagnosis.
A referral to Hospice of Davidson County can be made by anyone – a doctor, a member of the clergy, a family member or friend, or the patient themselves. To begin receiving hospice care, a patient’s physician must make a determination that he or she is appropriate for Hospice. This is made by certifying that the patient has a limited life expectancy, generally six months or less.
This is a common misconception. At Hospice of Davidson County, about 40 percent of our patients have a cancer diagnosis. Other diagnoses may be heart disease, stroke, autoimmune diseases, and traumatic brain injury.
According to a national study conducted in 2007, patients who opt for hospice care live an average of one month longer than similar patients who did not choose hospice. Additionally, patients under hospice care who receive significant doses of morphine and other comfort medications live the same or longer than those who do not, according to the International Association of Hospice & Palliative Care (IAHPC, 2010).
Hospice care with Hospice of Davidson County is provided wherever the patient may be, whether in their own home, a family member’s home, a nursing home, or an assisted living facility. Hospice care is also delivered at the county’s only inpatient Hospice unit – The Henry Etta & Bruce Hinkle Hospice House.
Hospice is for anyone facing a life-limiting illness, regardless of age. At Hospice of Davidson County, we provide hospice care for patients of all ages, not just adults.
Hospice care can be provided as long as the patient is certified as hospice appropriate. A patient can be re-certified for additional 60 and 90 day periods following the initial six months or less diagnosis. The Medicare Hospice Benefit is an unlimited benefit.
Medicare, Medicaid, and most private insurance companies cover hospice care. Hospice of Davidson County does not turn away those who do not have coverage or the ability to pay for care received.
Under the Medicare Hospice Benefit, beneficiaries elect to receive pain and symptom management for their hospice diagnosis by waiving the standard Medicare benefits for treatment of an illness. The beneficiary, however, may continue to receive the Medicare benefit for treatment for other conditions unrelated to the Hospice diagnosis.
Hospice Benefits are available to Medicare beneficiaries who:
- Are certified by a physician as having a life-limiting diagnosis
- Sign a statement choosing hospice care using the Medicare Hospice Benefit
- Enroll in a Medicare-certified Hospice program
The Medicare Hospice Benefit covers the following services as they relate to the hospice diagnosis:
- Physician services for medical oversight of the patient’s care
- Home care visits by registered nurses to monitor the patient’s condition and care
- Home health aide visits to assist with dressing, bathing, and personal needs
- Spiritual support for the patient, if desired
- Social work or counseling services
- Medical equipment
- Medical supplies
- Medications for symptom control and pain management
- Volunteer support
- Dietary counseling
- Bereavement counseling and support services
Services for conditions unrelated to the Hospice diagnosis and services not addressed on the plan of care arranged by Hospice of Davidson County are not covered by the Medicare Hospice Benefit.
Medicare pays Hospice directly for a patient’s care. Patients can be billed up to five percent for outpatient drugs, pain management, and symptom control. If the service is used, the patient may also be responsible for five percent of the Medicare payment amount for respite care. Patients are also responsible for room and board at facilities, if necessary.
The Benefit provides hospice services delivered in hospice facilities, hospitals, long-term care facilities, and inpatient hospice units. However, the Benefit does not pay for room and board. In some instances, Medicaid will cover these expenses.
A patient has the right to change to another hospice at any point, as long as the new hospice is Medicare-approved.
A patient can stop receiving hospice care at any time, for any reason. If a person stops hospice care, the standard Medicare Benefits are restored. Some reasons a person may stop receiving hospice care include:
- A person’s disease goes into remission
- A person’s condition changes such that the patient no longer has a six month or less life expectancy
- A patient decides they want to try curative treatment once again
At any point, a patient may return to hospice care as long as the eligibility criteria are met and certification by a physician is received.