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What is hospice care?
Hospice care provides compassion and comfort to terminally-ill patients during the final stage of their life. The focus of hospice care is on reducing pain and discomfort, not treating or curing the condition. Care is provided at the patient’s home, long-term care facility or, occasionally, in a hospital or an outpatient hospice facility.
What services does hospice care include?
Hospice care services vary depending on the provider and the nature of the patient’s condition, but typically include:
- Home health aide and homemaker services
- Doctor and nursing services
- Pain management / prescription drugs
- Medical equipment and supplies (e.g. wheelchairs, bandages)
- Physical, occupational and speech therapy
- Dietary and nutrition counseling
- Social work services
- Grief counseling for patients and their families
- Spiritual counseling for patients and their families
- Short-term respite care for relatives and other caregivers
- Short-term hospital care for pain or symptom management
What services are not included with hospice care?
The focus of hospice care is to maximize the patient’s quality of life during the final stage of their illness. It does not aim to treat or reverse the patient’s condition, or to postpone or accelerate the patient’s death.
Although a patient’s hospice team may arrange short-term hospital care for pain management in some cases, it does not typically include room and board, emergency room services or ambulance transportation.
How much does hospice care cost and who pays for it?
The cost of hospice care varies depending on the provider and the nature of a patient’s condition. However, since hospice care has such robust coverage under Medicare and most private health insurance plans, many patients end up paying very little or nothing at all out of pocket.
People often use the following methods, or a combination of the following methods, to pay for hospice care:
Medicare Part A covers the cost of hospice care for eligible patients. To be eligible, a patient must:
- Have a life expectancy of six months or less, as determined by two physicians (usually the hospice doctor and the patient’s primary care doctor).
- Agree to receive palliative care (managing pain/comfort) as opposed to treatment aimed at curing or reversing the illness.
- Choose hospice care over all other available Medicare-covered treatments.
Medicare is available to U.S. citizens who are 65 years old or older, as well as people of all ages with end-stage-renal-disease and younger adults with certain disabilities.
For those who are not enrolled in Medicare, most private health insurance plans will cover some or all of the costs associated with hospice care.
Hospice care is covered in full by the VHA Standard Medical Benefits Package and is available to all enrolled veterans who have six months or fewer to live. As with other types of coverage, patients must agree to receive palliative care and stop all treatments that aim to cure or halt their illness.
Medicaid covers the cost of hospice care for adults who meet their state’s financial eligibility requirements and for children who have certain disabilities. Medicaid coverage is very similar to Medicare coverage, but it also covers 95 percent of room/board costs for patients receiving hospice care in a nursing facility. In this case, Medicaid pays the hospice provider for room/board and the hospice provider pays the nursing facility.
How to find the best hospice care for your loved ones.
Find a hospice care provider near you. Hospice care involves a “care team” made up of home health aides, doctors, nurses, social workers, spiritual/religious advisors, bereavement counselors and volunteers. Choosing a hospice provider with an office near you makes it easier to coordinate schedules and ensure that your loved one receives quality, comprehensive care.
Read online reviews and ask friends for recommendations. Search Care Listings to read reviews of hospices based on other families’ experiences. Reach out to your own friends and relatives to see if they’ve had a positive or negative experience with a local hospice provider.
Review Medicare reports and patient survey results. Medicare’s Hospice Compare tool makes it easy to see how each provider stacks up against national averages for key quality indicators. It also summarizes the results of patients surveys, which cover topics like communication with the family, emotional and spiritual support, help for pain and symptoms, and other key areas of concern.
Ask about availability on nights and weekends. Some hospices have limited support available should you need assistance outside of your normally scheduled care hours. Ask the provider which members of the care team (nurses, counselors, chaplains, etc.) will be available should you need them on short notice, especially during nights and weekends.
Enquire about staff/volunteer training, credentials and ratios. Ask the provider if staff are trained and credentialed in palliative care in addition to their medical qualifications. Check to see if staff are assigned a maximum number of hospice patients at a time in order to maintain a high quality of care.
Consider the size, structure and ownership of each provider. Some hospices are small, independent companies, while others are part of large healthcare corporations. There are for-profit hospices, nonprofit hospices and government-managed hospices. Some are faith-based, others are secular. Choose the provider that best aligns with your family’s needs and beliefs.
