The word “hospice” is common in our society. But sometimes there is confusion over what hospice is, as if it were a particular place where one goes to die. In reality, it is a type of care and a philosophy of care that is available almost everywhere a person lives. It focuses on comfort care, addressing the symptoms of those at the end of life.The hospice philosophy and care were designed to address not only the physical issues that one experiences at the end of life but recognizes many other things that are going on as well, including physical, emotional, social, or spiritual symptoms. It can take place as an inpatient facility devoted to hospice care,in a nursing home, through visiting nurse programs in the patient’s home, or at an assisted living center.
In order to qualify for entry into a hospice the patient must have received a terminal diagnosis of six months or less. There are two kinds of hospices,profit and nonprofit. The difference between these two types is the business model. They both depend on government and insurance reimbursement to keep their doors open. A for profit hospice has owners and stockholders, they are expecting a return on their money. A nonprofit hospice has a board of directors and must do fundraising to raise additional operating capital.
In hospice, the longer the length of stay helps balance the more expensive patients only in hospice for a short time. The most expensive time in hospice care is at the beginning and at the end of care. Most of the high intensity care takes place in the first two weeks of hospice care and the last two weeks of hospice care.
Most of those who work in the hospice area are dedicated individuals called to do the work they are performing. The goals of any good hospice are the same, to provide high quality patient care by employees who are highly trained and operate by offering heart centered service.
When it comes to placing family members in hospice care, it is critical for families to ask questions to help make more informed decisions. Personal recommendations and your own feelings when visiting the hospice are the most important things to consider. When visiting the place you are considering, talk with the available staff. Look around you. How clean is it? How do the patients look? What is the ambiance?
In addition, you need to be knowledgeable about the services you are entitled to receive. Be assertive when advocating for the needs of your loved one and your family.
Things to Take into Account when Choosing Hospice
Contact the National Hospice and Palliative Care Organization or the Hospice and Palliative Nurses Association to see what you can find out about a hospice.
Find out how Medicare benefits work when someone is in hospice.
You may also wish to get referrals from friends and hospital or nursing facility nurses. They are the front line in dealing with families and hospice care and often have very good information.
Is the hospice for profit or nonprofit? Who owns it, and how is it run? Do they expect you to make a donation? Do they have any religious restrictions on the people it accepts?
If considering an inpatient facility, be aware of, for lack of a better term, the “energy” you feel when you are there. Sometimes this can come in terms of visual cues—how well the facility maintained, how clean it is, and soon. Sometimes you just get a sense of peace or of “coming home” when you enter one of these facilities. Find out what kind of accommodations are available for visitors. Can people stay overnight? Is there a playground or place for children? Are pets allowed?
When talking with the representative of the hospice, find out what services the hospice offers. See if you can talk to family members of patients who have gone through the program. Ask about their experience with the services.
Ask what happens after a patient is finished with the care at the hospice. What grief support do they provide or offer?
Families should talk with several hospice organizations and not sign anything until they have had time to think about it.