FREQUENTLY ASKED QUESTIONS ABOUT HOSPICE CARE

At the end of a life limiting illness there may come a time when the person chooses to stop aggressive treatment efforts to change the course of the disease and seek comfort care. In your role as a caregiver, this may be an appropriate time to discuss the option of hospice care with your loved one.

What is Hospice and Palliative Care?

Originating in the medieval ages, the term hospice meant lodging for travelers that provides comfort and security. The modern hospice approach to care focuses on comfort and dignity for the dying patient and their loved ones. Each patient is cared for in a manner that allows that person to die as they have lived, in harmony with his or her lifestyle. The focus is on caring, not curing. This approach is called palliative care and aims for pain relief and symptom control rather than cure. This philosophy is at the heart of hospice care and is shared by the program's highly trained staff. Hospice patients are cared for by a team of physicians, nurses, social workers, counselors, hospice certified nursing assistants, clergy, therapists and volunteers. Hospice care is available to anyone regardless of age or type of illness. The basic principles of Hospice care are:

• Death with dignity. End-of-life care that eases both physical and emotional pain.
• Palliative care. To achieve the best quality of life through relief of suffering and control of symptoms.
• Individual control over life. Care that respects the choices of the dying and involves the patient in all aspects of their care.
• Significance of time. To learn to use time wisely to do what matters most.
• Elimination of isolation for the patient, family and friends. To work together to support the dying person.
• Importance of family. Family and friends are fundamental to the well-being of the patient and should be involved in all aspects of their care.

Does hospice provide any services for the family of the dying patient?

Hospice understands that those who are close to a dying person experience the dual pains of shared suffering and of anticipated loss. The entire family is considered to be the patient unit and care is provided to all members as needed. Hospice provides continuing support for caregivers for at least one year following the death of a loved one and sponsors bereavement groups and grief support groups.

What kind of services does hospice provide?

The program provides: medical and nursing care, medical equipment and supplies, medication therapy for pain and symptom control, home health aide and homemaker services, social work services, physical, occupational and speech therapies, counseling, respite care, religious support and the coordination of all services needed by the patient and family. Respect for the individual's ethnicity, cultural beliefs, social and sexual preferences are reflected in the services and program of hospice care.

Can my loved one remain at home and receive hospice care? All efforts are made to allow the person the comfort of dying at home. The hospice care team delivers services to the majority of patients in their personal residences. However, hospice care can also be provided in a freestanding hospice building, hospital or nursing home.

Is the cost of hospice care covered by insurance? Hospice coverage is widely available and is covered by Medicare, Medicaid (ALTCS) and by most private insurance providers. To be sure of coverage, the person should check with their employer, health insurance provider, or ALTCS/AHCCCS. Most hospices will provide care for anyone who cannot pay using money raised from the community, memorials and/or foundations.

If my relative is covered by Medicare, will there be any additional expenses to be paid? Medicare covers all services and supplies for the hospice patient related to the terminal illness. Some hospices may require the patient to pay a small co-payment for medications and for respite care. The person should find out about co-payment when selecting a hospice.

How do I know if my loved one is eligible for hospice care? It is required that a patient entering hospice care have an attending physician. Most physicians know about hospice care. The patient and family should feel free to discuss hospice with their physician at anytime during a life limiting illness. Other criteria for acceptance into hospice include:

• The patient must have a diagnosis of a terminal illness.
• The disease is beyond the state of aggressive treatment for cure, and the general life expectancy is less than six months (some hospice programs accept persons with a life expectancy of less than one year).
• Both the patient and family wish to enter the hospice program.
• The physician agrees to the referral and will continue to attend to the patient.
• A competent caregiver is available to the patient in the home if homecare is recommended.

At the end of a loved one's life, while caregivers may feel pain and sadness, they have the opportunity to grow stronger and more courageous with the support provided by a caring hospice program. Hospice is not about death, but the quality of life as it nears its end, for all concerned - the patient, their family and friends.