Hospice Care at Home

Hospice is a concept of care and not a specific place of care. However most of our loved one's near end of life strongly voice the desire to spend their last months at home. Hospice care gives families support on many levels to honor their loved one's wishes to die at home.

Hospice offers a comprehensive team approach tailored to meet the physical, spiritual, emotional, and social needs of a loved one who is facing a life threatening illness. Hospice emphasizes palliative or comfort measures rather than curative treatments but never in a way to hasten the dying process.

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Experienced nurses under a doctor's supervision focus their efforts on maximizing a loved one's comfort through pain management and other adverse symptomatic relief. Physical therapists help maintain mobility and independence and home health aides lend a hand with personal hygiene. Social workers offer counseling services and clergy give spiritual support. Volunteers may be available for relief with household chores, meals, transportation or to simply sit with your loved one. Knowledgeable hospice workers refer families to support groups and additional services in their communities.

All persons who have a limited life expectancy regardless of age or type of illness, although cancer still most prevalent, may receive hospice care. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course. Hospice care is covered under Medicare Part A (Hospital Insurance), Medicaid, and most private insurances. (See below eligibility criteria)

Medicare Coverage

You are eligible for Medicare hospice benefits when you meet all of the following conditions:

  1. You are eligible for Medicare Part A (Hospital Insurance)
  2. Your doctor or the hospice medical director certify that you are terminally ill and probably have less than six months to live.
  3. You accept palliative (comforting) care instead of treatment to cure your terminal illness.
  4. You sign a statement choosing hospice care instead of routine Medicare covered benefits for your terminal illness.

"Traditional" Medicare will still pay for covered benefits for any health problems that are not related to your terminal illness.

Hospice Care Supplemented with Home Care

The scope of Hospice programs varies from one community to another and it may be necessary to supplement your loved one's care with some additional caregivers. Family caregivers are often in over their heads managing a dying loved one's care at home and desperately need extra help. When the need for further care arises beyond that which your hospice program can provide then non-medical homecare agencies need to be called upon to assist.

Non-medical home care agencies furnish caregivers including nurse assistants, companions and homemakers to complement hospice care already provided. Most families privately pay for these non-medical services but long term care insurance, some Medicaid and Veterans programs may help as well. Essentially your approach to offset homecare costs is to receive the maximum services available from Hospice and supplement as needed with privately pay services.

Hospice Care in a Facility

The majority of hospice care for loved ones is provided for in their own homes or the homes of family members. However "Home" may also be more broadly construed to include services in a home-like setting operated by a hospice program in nursing homes, hospitals, assisted living centers and residential care homes. Short-term hospice care may also be rendered in a hospice facility for respite care, symptom management or during final days.

Many Americans do not know that hospice care can be provided in the home, and most do not realize that hospice care can be fully covered through Medicare. Fortunately through public education, a growing number of Medicare beneficiaries are taking advantage of the quality care provided through their hospice benefit. Misguided and negative attitudes about hospice are justly being replaced with enlightened and positive opinions. The overwhelming majority of families who have experience with hospice express undue gratitude for the compassion and kindness freely bestowed on them.

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