For individuals and families to choose hospice care is an important decision that can add life to each and every day for someone with a life-limiting illness, in addition to providing support to the family during this difficult time. One of the best ways to choose a hospice is to ask questions. A local hospice provider should be more than willing to help individuals understand the available services and how they might be appropriate for your situation.
Hospice offers palliative care that seeks to comfort, rather than cure. Palliative Care is intended for individuals with an incurable disease resulting in a limited life expectancy that is certified by a physician. Hospice offers comprehensive, compassionate care coordinated by your attending physician, our medical director, and an interdisciplinary group to provide for the physical, psychosocial, spiritual and emotional needs of our patients and their family members.
No, hospice care is available to patients with a life limiting diagnosis who want medical care for comfort rather than curative care. The benefit covers the last six months of life.
A person facing a terminal illness is appropriate for hospice when the following conditions are met:
Some of the diagnosis for hospice care include:
Engrace Hospice provides services in every patient care setting.
This enables you to spend your final, most important days in a familiar, comfortable environment, surrounded by your loved ones, who can focus more fully on you while supported by hospice staff.
Medicare, Medicaid, VA Benefits and most private insurance plans cover the cost of hospice care.
Hospice is a fully covered Medicare/Medicaid benefit, unlimited in length and is also covered by many private insurance companies. Covered services include clinical services, medications, supplies and equipment related to the hospice diagnosis with no out-of-pocket expense to the patient.
Referrals may come from any source (family, friends, clergy, healthcare workers, etc.), but patients must be assessed by the hospice medical director for appropriateness of admission in consultation with the patient’s attending physician.
No, hospice does not hasten or postpone death. It is care provided to patients to make them more comfortable and peaceful at the end of their lives.
It’s ok. If you choose to seek aggressive medical treatment, hospice may not be for you. You have to qualify for hospice, but you can opt out at any time for as long as you like. You can opt back in later, as long as you qualify.
Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones.
Typically, hospice care starts as soon as the formal request or a “referral” is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.
Every hospice patient has access to a hospice physician, registered nurse, social worker, nursing aide, hospice volunteer, and chaplain (also known as the interdisciplinary team). For each patient and family, the interdisciplinary team writes a care plan with the patient/family that is used to make sure the patient and family receive the care they need from the team. Typically, full-time registered nurses provide care to about a dozen different families. Social workers usually work with about twice the number of patients/families as nurses. If needed, nursing aides, who provide personal care to the patient, will visit more frequently. All visits, however, are based on the patient and family needs as described in the care plan and the condition of the patient during the course of illness. The frequency of volunteers and spiritual care is often dependent upon the family request and the availability of these services. Travel requirements and other factors may cause some variation in how many patients each hospice staff serves.
Hospice care is available “on-call” after the administrative office has closed, seven days a week, 24 hours a day. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well.
Many patients may have pain and other serious symptoms as illness progresses. Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. Because keeping the patient pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice. Hospice staff works with the patient’s physician to make sure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan. The care plan is reviewed frequently to make sure any changes and new goals are in the plan.
Hospice volunteers are generally available to provide different types of support to patients and their loved ones including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members. Because hospice volunteers spend time in patients’ and families’ homes, each hospice program generally has some type of application and interview process to assure the person is right for this type of volunteer work. In addition, hospice programs have an organized training program for their patient care volunteers. Areas covered by these training programs often include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss, grief and bereavement support.
Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, nursing aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.
Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.
Many hospices use tools to let them see how well they are doing in relation to quality hospice standards. In addition, most programs use family satisfaction surveys to get feedback on performance of their programs. To help hospice programs in making sure they give quality care and service, the National Hospice and Palliative Care Organization has developed recommended standards entitled “Standards of Practice for Hospice Programs” as one way of ensuring quality. There are also voluntary accreditation organizations that evaluate hospice programs to protect consumers. These organizations survey hospices to see whether they are providing care that meets defined quality standards. These reviews consider the customary practices of the hospice, such as policies and procedures, medical records, personal records, evaluation studies, and many cases also include visits to patients and families currently under care of that hospice program. A hospice program may volunteer to obtain accreditation from one of these organizations.
A growing number of hospice programs have their own hospice facilities or have arrangements with freestanding hospice houses, hospitals or inpatient residential centers to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life when they need extra care. However, care in these settings is not covered under the Medicare or Medicaid Hospice Benefit. It is best to find out, well before hospice may be needed, if insurance or any other payor covers this type of care or if patients/families will be responsible for payment.
Engrace Hospice provides a comprehensive range of services to meet the physical, emotional, and spiritual needs of patients and their families. Our services include:
All services are tailored to the individual needs of each patient and family.
Absolutely not. While hospice care is often associated with cancer, it is available to anyone with a life-limiting illness, regardless of diagnosis. We provide care for patients with various conditions including heart disease, lung disease, kidney disease, liver disease, dementia and Alzheimer's disease, ALS, Parkinson's disease, HIV/AIDS, stroke, and other terminal conditions. Any disease that has reached an advanced stage where the focus shifts from cure to comfort may qualify for hospice care.
Respite care is a benefit that provides temporary relief to caregivers by allowing the patient to be cared for in a Medicare-approved facility (such as a nursing home or hospice inpatient unit) for up to five days at a time. This gives family caregivers a much-needed break to rest, attend to personal matters, or simply recharge. Respite care is covered under the Medicare Hospice Benefit and can be used multiple times as needed, giving caregivers the opportunity to take care of themselves while ensuring their loved one continues to receive professional care.
Yes, hospice patients can go to the hospital if needed. However, one of the goals of hospice is to manage symptoms and crises in the comfort of your home to avoid hospitalizations. If hospital care becomes necessary for symptom management that cannot be provided at home, the hospice team will coordinate this care. It's important to contact your hospice nurse first before calling 911 or going to the emergency room, as many situations can be managed at home with hospice support. This coordination helps ensure continuity of care and avoids unnecessary hospitalizations.
There is no fixed time limit for hospice care. Under the Medicare Hospice Benefit, patients are initially certified for two 90-day periods, followed by an unlimited number of 60-day periods. As long as the patient's physician and the hospice medical director continue to certify that the patient has a life expectancy of six months or less if the illness runs its normal course, hospice care can continue. Some patients may actually improve while receiving hospice care and may be discharged if they no longer meet the eligibility criteria, though they can return to hospice if their condition changes.
Hospice covers all medications related to the terminal diagnosis and for symptom management and pain relief. This includes:
The hospice team coordinates all medication deliveries and equipment needs, ensuring everything arrives at your home promptly. Medications for unrelated conditions may continue to be covered by the patient's regular insurance or Medicare Part D.
When a patient passes away, the family should contact Engrace Hospice. A hospice nurse will come to verify the passing and provide immediate support. The hospice team will:
Our support doesn't end with the patient's passing. Our bereavement team provides ongoing grief counseling, support groups, check-in calls, and memorial services to help families through their grief journey.
Hospice nurses are specially trained in end-of-life care, pain management, and symptom control. Unlike nurses in hospitals or clinics who focus on curing illness, hospice nurses focus entirely on comfort, quality of life, and supporting the patient and family through the dying process. They are experts in:
Hospice nurses visit patients in their homes and are available 24/7 for support and guidance.
Yes, patients who live alone can receive hospice care. However, they need to have a plan for when they need assistance. Hospice staff can visit regularly, but they cannot provide 24-hour care in the home. For patients living alone, options may include:
The hospice social worker can help explore options and resources to ensure the patient's safety and well-being.
Choosing hospice doesn't mean giving up hope—it means changing what you hope for. Instead of hoping for a cure, patients and families can hope for comfort, dignity, quality time together, relief from pain, and a peaceful death. Many families tell us they wish they had started hospice sooner because it allowed them to focus on spending meaningful time together rather than rushing to appointments or dealing with hospitalizations. Hospice helps patients live their remaining time as fully as possible, surrounded by loved ones in a comfortable environment. It's about living the best life possible until the end.
When selecting a hospice provider, consider asking the following questions:
At Engrace Hospice, we encourage you to ask these questions and any others you may have. We want you to feel confident in your choice of hospice provider.
Yes, you can continue seeing your regular doctor while receiving hospice care. Your personal physician can remain actively involved in your care plan and work collaboratively with the hospice medical director and team. Many patients choose to keep their primary care physician as their attending physician while on hospice. The hospice team will communicate regularly with your doctor about your condition, medications, and care plan. However, all treatments and medications must align with the hospice philosophy of comfort care rather than curative treatment.