Is Hospice Right for You?
Hospice care addresses the needs of patients and families during the last stages of an illness. Signing up for hospice doesn't mean giving up on all medical care. Hospice focuses on pain relief and symptom management, as well as emotional and spiritual end-of-life issues, instead of trying to cure the disease.
Hospice can be provided in a private residence, assisted living community, nursing home, or hospital.
When Should Hospice Care Begin?
Hospice is available to anyone with a life expectancy of 6 months or less. Often, patients choose hospice when the burden of curative treatment outweighs the benefits. Other signs a patient may be ready for hospice include unrelieved pain, repeated trips to the emergency room, and/or sudden or progressive decline in physical functioning or eating.
Hospice is appropriate when:
- A patients has a serious illness with a life expectancy of 6 months or less
- Comfort care and symptom management become the primary focus
- Curative treatment is no longer the patient's choice or option
Finding a Hospice Agency
Finding the right hospice provider takes a little research. Most communities have several hospice agencies serving the needs of patients and families. For your convenience, you can view a directory of hospice providers that are members of Ohio Council for Home Care & Hospice using the Locate an Agency tab on this website. You can search for agencies by location and services offered.
Questions to Ask
- Is the hospice licensed by the state of Ohio and is it Medicare and/or Medicaid Certified?
In order to be licensed and certified in Ohio, a hospice must meet all state licensure requirements as well as meet all conditions of participation of Medicare and Medicaid, which indicates the hospice accepts Medicare and Medicaid payment.
- If you are covered under commercial insurance, is the hospice an approved provider with your insurance company?
Most commercial insurance companies cover hospice care and have contracts with hospice providers for this purpose. When you utilize a hospice contracted with your insurance company, commonly referred to as "in network", your services are typically covered at a higher rate thereby reducing or eliminating your deductible and/or out of pocket expenses.
- What services does the hospice provide?
You should verify the hospice has all the services you are expecting. For example, all Medicare/Medicaid certified hospices are required to provide four levels of care, based on patient need, through an interdisciplinary team. However, some hospices offer complimentary therapies and/or services such as massage therapy or music therapy in conjunction with the four levels of care. Required Medicare and Medicaid services include physician, nursing, social services, counseling (bereavement, spiritual, and dietary), therapy services, and aide services. Hospice also provides medications, medical supplies, and medical equipment.
- What services are available 24 hours a day and what is the typical response time if a visit is needed during non-business hours?
All Medicare and Medicaid certified hospices are required to provide medical and nursing services 24 hours a day and have pharmaceutical access 24 hours a day. Many hospices provide 24 hour availability of social work and pastoral care services.
- Is the hospice staff certified in hospice care?
Certification in hospice and palliative care means the staff have had extra training in this area of expertise and have had to demonstrate their knowledge by passing an exam. Currently, certification is available for nurses, hospice aides, and social workers. Physicians who have additional training in hospice and palliative care and have passed an exam in these areas, are considered a board certified specialist in hospice and palliative care.
- Does the hospice provide care in facilities such as nursing facilities and assisted living facilities? If yes, which area facilities work with the hospice?
Hospices are not able to provide care in facilities unless they have a contract to do so. Facilities are not required to have contracts with hospices. If you already reside in a nursing or assisted living facility, you will want to know what hospice providers are able to serve you. Should you need to transfer to one of these types of facilities in the future, it is most often best for the continuity of your care if you are able to receive hospice services from the same hospice provider as you did prior to transferring to the facility.
- How and where does the hospice provide short-term inpatient care?
Short-term inpatient care is provided for pain and/or symptom management that needs to be managed in an acute care setting and cannot be managed in any other setting. The hospice may have its own hospice inpatient unit or contract with a Medicare-certified hospital or skilled nursing facility (SNF) to provide this care. You should check with the hospice to find out where they can provide short-term inpatient care and if the facilities where this is provided are ones you are comfortable using should you need short-term inpatient care.
- How and where does the hospice provide respite care?
Respite care is provided for periods of up to five days at a time to provide relief to a patient’s caregiver(s). This care can be provided in a hospital, nursing facility or hospice inpatient unit. As in question above, you want to determine if the facilities where the hospice provides respite care are ones you are comfortable using should you need short-term inpatient care.
- What type of care is provided by the hospice volunteers?
Volunteers often do the type of work that a friend of the family would provide. For example, providing companionship for the patient or staying with the patient for a short period of time to provide some respite for the caregiver.* Consider what services, if any, you would like to receive from a volunteer and determine if the hospice has volunteers who can provide this service.
- What type of bereavement services does the hospice provide?
All Medicare and Medicaid certified hospices are required to provide bereavement services for the individual and the family from admission to at least 12 months following the individual's death. You should determine if the services available would meet you and your family’s needs.
- How long after requesting services will it take to get signed up?
Hospice works with your family’s schedule and should be available to get you signed on to hospice services in a timeframe that works for you and your family.
*Custodial care is not covered by the Medicare or Medicaid hospice benefit. This means hospices do not provide 24-hour, 8-hour or other such care.