End-of-life care (5)
- Hospice care: Comforting the terminally ill
- Terminal illness: Supporting a terminally ill loved one
- End of life: Caring for a dying loved one
- see all in End-of-life care
- Grief: Coping with reminders after a loss
- Suicide grief: Healing after a loved one's suicide
- Infant death: Grief and the path to remembrance
- see all in Grief
Hospice care: Comforting the terminally ill
Who's involved in hospice care?
If you're not receiving hospice care at a dedicated facility, members of the hospice staff will make regular visits to your home or other setting to provide care and other services. Hospice staff is on call 24 hours a day, seven days a week. A hospice care team typically includes:
- Doctors. A primary care doctor and a hospice doctor or medical director will oversee your or your loved one's care.
- Nurses. Nurses will come to your or your loved one's home or other setting to provide care. Nurses also are responsible for coordination of the hospice care team.
- Home health aides. Home health aides can provide extra support for routine care, such as dressing, bathing and eating.
- Spiritual counselors. Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family.
- Social workers. Social workers provide counseling and support. They can also provide referrals to other support systems.
- Pharmacists. Pharmacists provide medication oversight and suggestions regarding the most effective ways to relieve symptoms.
- Volunteers. Trained hospice volunteers offer a variety of services depending on your needs, from providing company or respite for caregivers to helping with transportation or other practical needs.
- Other professionals. Speech, physical and occupational therapists can provide therapy, if needed.
- Bereavement counselors. Trained bereavement counselors offer support and guidance after the death of a loved one in hospice.
How is hospice care financed?
Medicare, Medicaid, the Department of Veterans Affairs and private insurance might pay for hospice care. While each hospice program has its own policy regarding payment for care, services are often offered based on need rather than the ability to pay. Be sure to ask about payment options before choosing a hospice program.
How do I select a hospice program?
To find out about hospice programs, talk to doctors, nurses, social workers or counselors, or contact your local or state office on aging. Consider asking friends or neighbors for advice. The National Hospice and Palliative Care Organization also offers an online provider directory.
To evaluate a hospice program, ask questions about the services offered. For example:
- Is the hospice program Medicare-certified? Is the program reviewed and licensed by the state or certified in some other way? Is the hospice program accredited by The Joint Commission?
- Who makes up the hospice care team, and how are they trained or screened? Is the hospice medical director board certified in hospice and palliative care medicine?
- Is the hospice program not for profit or for profit?
- Does the hospice program have a dedicated pharmacist to help adjust medications?
- What services are offered to a terminally ill person? How are pain and other symptoms managed?
- How are hospice care services provided after hours?
- How long does it take to get accepted into the hospice care program?
- What services are offered to the family? What respite services are available for the caregiver or caregivers? What bereavement services are available?
- Are volunteer services available?
- If circumstances change, can services be provided in different settings? Does the hospice have contracts with local nursing homes? Is residential hospice available?
- Are hospice costs covered by insurance or other sources, such as Medicare?
Remember, hospice stresses care over cure. The goal is to provide comfort during the final months and days of life.Previous page
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- Am I eligible for hospice and palliative care? U.S. Department of Veterans Affairs. http://www.va.gov/GERIATRICS/Guide/LongTermCare/Hospice_and_Palliative_Care.asp#. Accessed Nov. 27, 2012.
- El-Jawahri A, et al. Does palliative care improve outcomes for patients with incurable illness? A review of the evidence. Journal of Supportive Oncology. 2011;9:87.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 27, 2012.
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