Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
When should a decision about entering a hospice program be made and who should make it?
At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient and family.
Is all hospice care the same?
No. Many communities have more than one hospice. Medicare requires certified hospices provide a basic level of care, but the quantity and quality of all services can vary significantly from one hospice to another. To find the best hospice to fit your needs, ask your health care provider, clergy, social worker, or friends and family that have experienced hospice care firsthand. You may want to schedule a meeting with a prospective hospice to ask about their particular service philosophy.
What makes a not-for-profit hospice different from other hospices?
Although all hospices work with people facing terminal illness, the philosophy, policies, and services offered can vary greatly from one hospice to another. RMH is a free-standing, open access, not-for-profit organization, therefore, we never refuse a patient because of inability to pay and we never bill the family for the services we provide. We do not place families on a “waiting list” until we have an opening in our census. RMH absorbs the total cost of care for our patients who may be uninsured or underinsured. It is not only our mission to care for these families in need, it is our honor. We rely on the generosity of grateful families and community donors to help defray the expense of our charity care services.
Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
What does the hospice admission process involve?
One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. RMH has a Medical Director available to help patients that have no primary care physician. An evaluation will be made and, if hospice appropriate, admission forms will be completed.
Is there any special equipment or changes I have to make in my home before hospice care begins?
RMH will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.
How many family members or friends does it take to care for a patient at home?
There’s no set number. One of the first things the RMH team will do is prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice staff visit regularly and are always accessible to answer healthcare questions.
Must someone be with the patient at all times?
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. While family and friends do deliver most of the day to day care, hospices may have volunteers to assist with errands and to provide a break and time away for primary caregivers.
What specific assistance does hospice provide home-based patients?
Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness.
Does hospice provide care 24 hours a day, 7 days a week?
RMH has experienced staff members on call 24 hours a day, 7 days a week, 365 days a year. Hospice care does not include a nurse in the home 24/7. However, if additional caregiving support is needed, hospice professionals can assist the family in making decisions regarding transitional care such as private duty caregivers, assisted living care, nursing home care, etc.
Does hospice do anything to make death come sooner?
Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
Is caring for the patient at home the only place hospice care can be delivered?
No. RMH cares for patients in a variety of settings. Whether in their own home, a nursing facility, assisted living facility, or a hospital we provide exceptional healthcare attention and compassionate support during this process of life.
How does hospice “manage pain”?
RMH believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so we address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish, and they are sometimes joined by specialists schooled in music therapy, art therapy, massage, diet counseling, and pet therapy. Finally, various counselors, including clergy, are available to assist family members as well as patients.
What is hospice’s success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
Will medications prevent the patient from being able to talk or know what’s happening?
Usually not. It is the goal of RMH to have the patient as pain free and alert as possible. By constantly consulting with the patient, we have been very successful in reaching this goal.
Is hospice affiliated with any religious organization?
RMH is not affiliated with any religious organization.
Is hospice care covered by insurance?
Hospice coverage is widely available. It is provided by Medicare nationwide, by the Medicaid Advantage Program in Oklahoma (RMH is an approved OK provider), and by most private insurance companies. To be sure of coverage, families should, of course, check with their employer or health insurance provider. Remember, RMH does not discriminate based on the ability of a patient to pay for services.
If the patient is eligible for Medicare, will there be any additional expense to be paid?
The Medicare Hospice Benefit covers the full scope of medical and support services for a life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services. This benefit covers almost all aspects of hospice care with no expense to the patient or family. RMH never bills the family for services we provide.
If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?
The first thing hospice will do is assist families in finding out whether the patient is eligible for insurance coverage and/or resources they may not be aware of. RMH will provide hospice care for anyone without coverage, using money raised through memorial and individual charitable donations, grants and foundation gifts.
Does hospice provide any help to the family after the patient dies?
Yes. RMH provides continuing contact and support for caregivers and family members for at least 13 months following the death of a loved one. In addition, RMH sponsors monthly grief support groups for our patient’s family members and friends. These monthly meetings are also open to anyone in the community who has experienced a death of a family member, a friend, or similar losses.