End-of-life care (5)
- Hospice care: An option when confronting terminal illness
- Terminal illness: Interacting with a terminally ill loved one
- End of life: Caring for your dying loved one
- see all in End-of-life care
Grief (8)
- Grief: Coping with reminders after a loss
- Grief: A Mayo Clinic doctor confronts painful emotions
- Survivors of suicide: Healing after a loved one's suicide
- see all in Grief
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
continued:
Hospice care: An option when confronting terminal illness
What services are included in hospice care?
The range of hospice care services varies depending on the program you choose, and the status of your loved one's disease. You and your loved ones are actively involved in the care. Generally, hospice care services include:
- Care directed by a doctor who has training in providing hospice and end-of-life care — your loved one's primary physician remains in control, with assistance from the hospice care team
- Regular visits to the home by nurses who have training in hospice care, as well as 24-hour, on-call nursing support
- Help with daily needs, such as bathing, cooking, cleaning, or other needs
- If requested, visits from a chaplain
- Counseling services, both for the person in hospice and for the family members
- Social services support
- Respite care
- Medical equipment — such as hospital beds, bedside commodes, wheelchairs, oxygen — and medical supplies
- Medications to help control pain and symptoms
- Bereavement care for the family following the death
- Access to other therapies, such as physical, occupational, speech and dietary therapies, as needed depending on your loved one's condition
Who's involved in hospice care?
Hospice care services offer a team of professionals that work to maximize comfort for the terminally ill person and to help support the family members and loved ones. A hospice care team consists of:
- Doctors. Both your loved one's primary care doctor and the hospice's medical director oversee their care. The primary care doctor remains the main doctor, but the hospice medical director often has added expertise in symptom management and end-of-life care that can supplement the care provided by the primary doctor.
- Nurses. Nurses come to your home or other care setting for regular evaluations and report back to doctors. Nurses also provide help and support for family members and friends. They can address any concerns you have about end-of-life issues and symptom management. How often nurses visit depends on how much care you loved one needs. Nurses are available at all times for emergency visits in case a change or crisis develops. They can also offer support and guidance at the time of death.
- Home health aides. Home health aides and homemaker services can assist in caring for the person in hospice care. Home health aides provide extra support for routine care, such as dressing, bathing and eating.
- Spiritual counselors. Chaplains, priests, lay ministers or other spiritual counselors are available. Many people in hospice care have connections to some spiritual services in their community, but the hospice can provide additional services, if desired.
- Social workers. Social workers provide counseling and support. They can also help you sort out insurance and other financial concerns.
- Volunteers. Trained hospice volunteers provide a variety of services, such as staying with the person in hospice while loved ones or family run errands, providing transportation assistance or just participating in activities that provide meaning and enjoyment, such as playing cards with or reading to the person in hospice care.
- Bereavement counselors. Trained bereavement counselors offer support and guidance for family members during and after the death of the person in hospice. Bereavement counselors continue to provide support for up to a year after your loved one's death.
How is hospice care paid for?
Medicare, Medicaid and private insurance all may be used to pay for hospice care. Medicare is a common source of payment for many. To receive reimbursement from Medicare for hospice care expenses, in general:
- The person seeking hospice care must be eligible for Medicare Part A. Medicare Part A is the portion of Medicare that traditionally covers hospital and inpatient expenses. It also covers hospice care.
- Your loved one's doctor and hospice medical director must certify that your loved one is eligible to receive hospice services.
- The person seeking hospice care must agree to receive hospice care instead of treatments meant to treat or cure your illness.
- Hospice care must be provided by a Medicare-certified hospice program. Most hospice programs in the United States are certified by Medicare, but check to be sure.
Both Medicare and Medicaid help cover the cost of the hospice professional services, medications related to the terminal illness, and all supplies and equipment necessary to provide care within a home setting. Private insurance coverage varies.
Some hospice programs provide services on a sliding fee scale, based on your ability to pay. Check with officials at the hospice program about payment options. Most hospice programs have social workers and others who can talk with you to explain the various options.
How to select a hospice care program
Most hospice programs are run by nonprofit, independent organizations. Some are affiliated with hospitals, nursing homes or home health care agencies, and some are for-profit organizations.
You can learn about existing hospice programs from doctors, nurses, social workers and your local or state office on aging. You also might check with friends or neighbors who may have used such services before. The National Hospice and Palliative Care Organization offers more information on hospice, including a provider directory, on its Web site. Also check to see if your state has a statewide hospice organization.
When evaluating available programs, ask the following:
- Is the hospice Medicare-certified?
- What services are available to the person who's dying?
- How are hospice care services provided after hours?
- How long does it take to get accepted into the hospice care program once a referral is made?
- What services are offered to the family?
- What bereavement services are available?
- How involved are the family members?
- How involved is the doctor?
- Who makes up the hospice care team, and how are they trained or screened?
- How will the individual's pain and symptoms be managed?
- If circumstances change, can services be provided in different settings? Does the hospice have contracts with local nursing homes? Is residential hospice available?
- Is the program reviewed and licensed by the state or certified in some other way?
- Are all costs covered by insurance or other sources (such as Medicare)?
Care over cure
Hospice care addresses two big fears a dying person may have — the fear of pain and the fear of being alone. The hospice staff administers appropriate pain relief, provides nursing care, and offers ongoing reassurance and support to your loved one and family members. Together, you can see to it that your loved one isn't alone during this last and important phase of life.
Previous page(2 of 2)
