Hospice care is designed to provide support to you and your loved ones during the final phase of life.

Hospice, sometimes referred to as palliative or end of life care, is care provided to support patients who are chronically or terminally ill and have a prognosis of 6 months or less to live. Hospice care focuses on treating the person, rather than the disease, and focuses on quality of life. Hospice care professionals address emotional and spiritual needs in addition to physical ones.

What types of services are offered in hospice?

Choosing hospice is not hastening death or giving up. In hospice, curative treatments are no longer the patient’s choice or option; instead comfort, care, and symptom management become the main focus. Each patient receiving hospice care gets an individualized care plan that is updated as necessary to address the physical, emotional, and spiritual pain that accompanies terminal illness. Additionally, hospice care provides support to family, friends, and caregivers through the patient’s end-of-life process.

Hospice Care is designed to be supportive and focus on comfort and quality of life. The goal is to allow individuals to have an alert, pain-free life and live each day as fully as possible. Typical services provided by hospice include emotional counseling, homemaker services, dietary counseling,
and medical supplies and equipment.

Types of Hospice Care:

• Routine Home Care – the most common hospice service and is delivered in the patient’s home
• Continuous Home Care – far more intensive than routine home care and involves continuous care to manage a patient’s acute symptoms
• General Inpatient Care – typically for treating symptoms that cannot be managed through home care and can be provided in a hospital, long-term care residence like a nursing home, or in a free-standing hospice.
• Respite Care – short-term inpatient care that is intended to be for the benefit of family caregivers when a break is needed

Hospice at Home vs. Hospice in a Facility

Hospice care can be provided in a setting that the patient and family prefer. Though hospice care is most often provided in the patient’s home, there are also stand-alone hospice facilities, nursing homes, assisted living facilities, and hospitals that provide hospice care depending on the patient’s medical needs.

How to Choose Hospice Care

There are four main steps involved in selecting a hospice care provider for yourself or your loved one:

1) Understand Your Needs

Meet with a medical professional to identify if hospice care is the best choice for your or your loved one. If the patient has a specific medical need (diabetes, wound care, etc.) or spiritual needs, you can narrow down
your search by evaluating hospice care centers based on what specialty care they provide.

2) Verify Your Insurance Coverage

Most hospice care in the U.S. is provided by the Medicare Hospice Benefit. Many private insurance companies also provide coverage for hospice care, though there are variations in qualifications and covered benefits with private insurers.

3) Compare Facilities Based on Quality Measures

Different qualities to compare between hospice care providers are how pain assessments are conducted, how well the care professionals take into account patient’s beliefs during the cycle of care, and whether the hospice care center respected the patient’s values during their stay. followupcare.org provides these metrics, and more, for each facility and measures them against state and national averages to help put them in context and make the comparison process easier for you.

4) Talk to the Agency and Staff

You have the right to choose a hospice care center that provides you or your loved one with the care and services you need. Your choice should be honored by your doctor and care team. Ask the hospice agency how different situations are handled and how the patient needs will be addressed with their services.

Checklist of Things to Consider

Depending on where you live there could be one or several hospice organizations serving your community. If there are multiple hospices in your area, you can decide which hospice you want to care for you or your
loved one and let your physician know which one you prefer. This list of questions will help you go through the selection process. followupcare.org offers comprehensive profiles of every hospice provider in the country
to support your search.

• 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 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.
• 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.
• 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.
• If I need to go to a hospital or nursing home which ones does/doesn’t the hospice work with? If you have a preferred hospital or know that you may need to go to a nursing home, it’s important to find out which ones the hospice has contracts with so they can continue to provide your hospice services in this different setting.
• 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 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.
• 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.

If you determine that a loved one requires hospice care, the next step is to search facilities in your area. followupcare.org helps you search and compare hospice care by location and provides insightful quality data, patient reviews, and facility ratings to help you find sites that best fit your needs.