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Hospice care is medical support for those who are nearing the end of life. Patients whose life expectancy is 6 months or less begin treatment that is focused on comfort and symptom management. Care is provided with a goal of quality over quantity.

Hospice care includes:

• Medication for symptom control and/or pain relief

• Medical equipment such as oxygen, catheters, hospital beds, wheelchairs, or other mobility aids

• Access to an emergency physician or nurse 24-hours a day

• Medical supplies for at-home care

• Personal care assistance

• Grief counseling and emotional support

Who needs hospice?

Hospice care may be provided to anyone who is terminally ill or expected to live 6 months or less. A doctor and hospice care team must agree that a person's life is nearing its end to qualify. Some common diagnoses of those who receive hospice care include heart disease, dementia, and lung disease, though there remains a myriad of other illnesses and bases for qualification.

Important: Hospice care has no duration limit. Even though a patient must be determined near the end of life when accepted, care can exceed 6 months, as long as their condition is considered life-limiting.

Where & how is hospice care received?

Hospice care can be provided wherever a patient lives. This includes their family home, nursing home, assisted living facility, or even a hospital under certain circumstances. Some hospices also provide their own residential facilities. A care team collaborates with family members to choose the best treatment options.

There are 4 primary types of hospice care.

Routine Home Care is provided wherever a patient lives by a team of nurses and other aides when a patient is not in a current state of medical crisis. The care team makes frequent home visits to administer custodial and medical services. Routine home care may include:

• Skilled nursing

• On-call doctor or nurse practitioner

• Therapeutic care

• Medication for pain management or other symptoms

• Medical supplies

Continuous Home Care is necessary when a patient needs a nurse for longer than 8 hours a day in addition to other routine home care services. This type of around-the-clock care is usually provided when a patient is experiencing severe symptoms. This includes:

• Trouble breathing

• Constant vomiting

• Pain that has become hard to manage or unmanageable

General Inpatient Care is recommended when symptoms become too severe to manage at home. It is usually intended for short-term support. The goal is to get the patient back in the comfort of their own home as soon as possible.

Respite Care is for patients who receive most of their hospice care from family members. Respite care is when a person is allowed a short-term inpatient stay at a hospital or other facility for the sole purpose of giving their primary caregiver a break. After a period (usually a week) the patient returns home.

Who works in hospice?

Caregivers range from doctors to family members to volunteers. Who is administering care depends on the patient and family's needs. Common hospice care teams will include a combination of doctors, nurses, and home health aides. Other team members include:

• Social workers

• Bereavement counselors

• Therapists

• Spiritual counselors

• Volunteers

How can I pay for hospice?

Hospice can be paid for through Medicaid, private insurance, and out-of-pocket, though if a patient receives Medicare (65 and older), it is 100% covered (as long as the hospice provider is Medicare-approved). This means Medicare will pay for all medical and nursing services, pain management medication, medical equipment, grief counseling, and any other services necessary.

Important, Medicare does not cover:

• Treatments intended as a cure

• Prescription drugs intended to cure

• Room and board if residing in a nursing facility

Choosing hospice care

Obtaining the best possible care for you or a loved one nearing the end of life is important. Before choosing a hospice care provider, ask providers these questions:

• Is the program Medicare-approved?

• How soon can care begin?

• What levels of care are provided?

• How often do team members visit a home in routine home care?

• What medical services are available for in-home care? And, at what point do services necessitate an in-patient stay?

Be sure to ask your doctors for referrals and recommendations and take tours of facilities when offered.

Visit Senior Resource's Hospice Directory to find a program near you.