Question: Isn’t “hospice” a place or facility, as opposed to a service?

Answer: Hospice is not a place, but a philosophy of patient care. Hospice care can be given in any place the patient considers home, whether that is the patient’s personal home, an assisted living facility, skilled nursing center, or anywhere else.

Question: Can hospice care take care of a patient in his assisted living apartment or room, as opposed to his or her personal home?

Answer: Yes, hospice care can be provided anywhere a patient considers his or her home, including assisted living facilities, skilled nursing centers, independent living facilities or the patient’s personal home.

Question: Does a patient have to sign a “Do Not Resuscitate” (DNR) order in order for him or her to receive hospice care?

Answer: No, signing a DNR is not a prerequisite to receiving hospice care. In fact the hospice regulations state that hospice agencies cannot discriminate against patients because of choices related to advance directives.

Question: Can a patient receive hospice care while they are getting blood transfusions or chemotherapy regularly, if they are providing comfort to the patient?

Answer: If treatments such as chemotherapy, radiation, blood transfusions or similar are providing comfort to the patient, then the Medicare Hospice Benefit may cover them (but the patient would otherwise need to be eligible for hospice care with a life expectancy of six months or less if the illness runs its normal course).

Question: Is hospice just for patients with cancer, or can patients with other diseases such as Alzheimer’s also receive hospice care?

Answer: Many patients have other diagnoses other than cancer, such as advanced stages of chronic diseases like pulmonary disease, Alzheimer’s disease, renal disease, acquired immune deficiency syndrome and cardiovascular or neuromuscular diseases. In fact, nationwide, more than 60% of hospice patients have diagnoses other than cancer.

Question: Is it true that if a patient is on hospice that they are no longer allowed to go to the hospital to help control pain?

Answer: A primary goal with hospice care is to manage pain and other uncomfortable symptoms at the patient’s home outside of the hospital setting, but a hospice patient can always choose whether or not they wish to go to the hospital. The Medicare Hospice benefit does cover short-term general inpatient care in the hospital when a patient’s symptoms can no longer be managed at the patient’s home or assisted living setting.

Question: Are there any out-of-pocket costs to the patient associated with hospice care?

Answer: The Medicare and Medicaid Hospice benefits cover hospice services 100%, so for that reason there is no cost to the patient. However, if patients have private insurance or managed care, First State Hospice can assist in checking the patient’s benefit coverage to ensure that families and patients are aware beforehand of any possible out-of-pocket costs.

Question: Can a family member (or patient) initiate discussions about hospice care with a hospice agency such as First State Hospice, or does the family have to wait for the doctor to bring it up?

Answer: Patients and/or families can choose for First State Hospice to meet with them and discuss the benefit of hospice at any time. First State Hospice cannot provide hands-on hospice care to a patient without a physician’s order first, but we can and do work with each patient’s physician to identify each patient’s individual needs.

Question: Hospice seems so final – when and why should a patient or family consider it?

Answer: Before receiving hospice care, the patient must be eligible and understand that hospice concentrates on comfort care (palliative), and does not seek to cure. But patients do not need to be “ready to die” before going on hospice. Being on hospice helps patients and families deal with what is happening to them in their own timeframe and on their own terms. It is valuable to get hospice early to help patients prepare and get ready for what is happening; patients do not need to be ready prior to receiving care.

Question: Is hospice care the same as “palliative care”?

Answer: All hospice care is palliative, however, not all palliative care is covered by Medicare. Hospice care focuses on physical, spiritual and emotional support services for the patient and family including family counseling, bereavement services and assistance with end-of-life choices and decisions.

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