What is Hospice Care?

Hospice care is for people who are nearing the end of life. Hospice care services are provided by a team of health care professionals who maximize comfort for a terminally ill person by reducing pain and addressing physical, psychological, social and spiritual needs. To help families, hospice care also provides counseling, respite care and practical support.

Unlike other medical care, the focus of hospice care isn't to cure the underlying disease. The goal of hospice care is to support the highest quality of life possible for whatever time remains.Hospice care has been shown to make people who have incurable illnesses feel better and live longer. Enrolling in hospice care early might help you or your loved one develop a strong relationship with the hospice staff, who can help with preparation for end-of-life needs.

While most hospice care is provided at home, hospice care is also available at hospitals, nursing homes, assisted living facilities and dedicated hospice facilities.For instance, if a symptom can't be adequately managed by the hospice care team in a home setting, a hospital or stay in a long-term care community might be needed.

Hospice care is paid for by Medicare, Medicaid in most states, the Department of Veterans Affairs, most private insurance plans, HMOs, and other managed care organizations. Also, community contributions, memorial donations, and foundation gifts allow many hospices to give free services to patients who can’t afford payment. Some programs charge patients according to their ability to pay. Be sure to ask about your payment options before choosing a hospice program.

Checklist courtesy of the the National Hospice and Palliative Care Organization

Is the Hospice Medicare Certified?

Most hospices are certified by Medicare and are therefore required to follow Medicare rules and regulations. This is important if wish to receive hospice care as part of your Medicare/Medicaid coverage.

Has the hospice been surveyed by a state or federal oversight agency in the last five years?

Ask when the last survey was and if any deficiencies were noted and if so, have they been resolved.

Is the organization a NHPCO member and does it comply with all aspects of NHPCO’s Standards for Hospice Programs?

Ask if the hospice is a current NHPCO member, if it complies with NHPCO’s Standards and has completed the Standards Self Assessment, and if so, how recently they completed it.

Is the hospice accredited by a national organization?

Several organizations accredit hospices, surveying them to ensure they meet quality standards. Hospices are not required to be accredited but accreditation can be a reflection of its commitment to quality.

Does the hospice conduct a family evaluation survey?

Many hospices ask family members to complete a brief evaluation of their services after the death of a loved one. Ask for their most recent scores so you can see how previous patients and family members have rated their services.

Does the hospice own or operate a care facility to provide home-like care in a hospice residence, hospital or nursing home?

This may be important to you if the care needed is complex and/or family caregivers cannot care for the person at home.

Are clinical staff (physicians, nurses, social workers) certified or credentialed in hospice and palliative care?

There are several credentials that hospice professionals can achieve based on their knowledge of hospice/palliative care and their educational experience.

What services do volunteers offer, and if requested, how quickly will a volunteer be available?

Volunteers can provide a variety of services including friendly visits, light household chores, running errands, personal care, etc. If you want a hospice volunteer, be sure to ask how quickly one can be assigned and how they match volunteers to meet your needs.

Will staff come to the home if there is a crisis at any time of the day or night and on weekends? Who is available to make the home visit (nurses, doctors, social workers, chaplains)?

Hospice staff are available by phone to help you 24 hours a day, seven days a week. However, some hospices offer limited in- home support on nights and weekends, while others are able to send staff out to a patient’s home no matter when a crisis arises. Frequently a nurse is the best person to make a visit if it is a medical crisis, however, sometimes the crisis is best handled by a physician, social worker, chaplain or another member of the team. Ask if all members of the team are available in a crisis situation during nights and weekends.

What “extra” services does the hospice offer?

All hospices provide expert medical care, emotional and spiritual care, medicines, medical supplies and equipment, volunteers and grief support after the death of a loved one. In addition to these services some hospices offer specialized programs for children, people with specific diseases, “pre-hospice” care for individuals not yet medically-ready for hospice care and other “extra” services that may benefit your family.

How long has the hospice been operating in the community?

Again, length of time in the community may be important to you and your family.

How many patients at any one time are assigned to each hospice staff member who will be caring for the patient?

Some hospices assign a certain number of patients to each staff member and may be willing to share that information with you. That might influence your decision to receive care from a hospice.

What screening and type of training do hospice volunteers receive before they are placed with patients and families?

All volunteers must receive training or orientation on hospice care. Some hospices provide specialized training related to bereavement, pediatric care, nursing home care, etc.

How quickly can the intake/admissions staff come to begin the admissions process? Is someone available at nights or on weekends?

Some hospices are able to begin the admissions process and have someone begin hospice services at night or on weekends. If you are referred to hospice late in the day or on the weekend, a hospice’s ability to start services quickly might be very important.

What is the organization’s governance structure?

Whether or not the organization is a non-profit, for-profit, government, faith-based or part of a larger healthcare organization may be important to you and your family.

Is the hospice a We Honor Veterans Partner?

We Honor Veterans Partners have demonstrated their commitment to improving the care they provide to Veterans and their family members.

National Hospice and Palliative Care Organization: Understanding Hospice Care

The Mayo Clinic: Hospice Care: Comforting the terminally ill

Cancer.org: What is Hospice Care?

AARP Caregiving Resource Center: Facts about Hospice