Hospice offers medical care toward a different goal: maintaining or improving quality of life for someone whose illness, disease or condition is unlikely to be cured. Each patient’s individualized care plan is updated as needed to address the physical, emotional and spiritual pain that often accompanies terminal illness. Hospice care also offers practical support for the caregiver(s) during the illness and grief support after the death.
Hospice is something more that is available to patients and families when curative measures have been exhausted and life prognosis is six months or less.
List of Services
- Time and services of the hospice care team, including visits to the patient’s location by the hospice physician, nurse, medical social worker, home-health aide, chaplain/spiritual caregiver, volunteers, and bereavement counselor
- Medication for symptom control and pain relief
- Medical equipment like wheelchairs and walkers, and medical supplies like bandages and catheters
- Physical and occupational therapy
- Speech-language pathology services
- Dietary counseling
- Other Medicare-covered services needed to manage pain and other symptoms related to the terminal illness, as recommended by the hospice team
- Short-term inpatient care when adequate pain and symptom management cannot be achieved in the home setting
- Short-term respite care to support caregivers and help address or avoid “caregiver burnout”
- Grief and loss counseling for patient and loved ones
Not all services provided to patients enrolled in hospice care are covered by the Medicare Hospice Benefit. The benefit will not pay for:
- Treatment intended to cure your terminal illness or unrelated to that illness
- Prescription drugs to cure your illness or unrelated to that illness
- Room and board in a nursing home or hospice residential facility
- Ambulance transportation or care in an emergency room or inpatient facility unless the service is arranged by the hospice team or is unrelated to the terminal illness
For someone to receive hospice services, a hospice physician and a second physician (often the individual’s attending physician or a specialist) must certify that the person meets specific medical eligibility criteria. Generally, the person’s life expectancy must be 6 months or less if the illness, disease or condition were to run its typical course. However, patients admitted to hospice who live longer than six months may be re-certified by a physician or nurse practitioner for additional time on hospice service if their condition continues to decline. If their condition improves, they may be discharged from hospice service — with great care taken to ensure continuity of care by a primary care physician or clinic. These patient are eligible for hospice again if their condition begins to decline.
Care Comes to the Patient
Hospice services are provided in the setting that the patient calls home, which may be their private residence or that of a loved one, a hospital, assisted living center, or skilled nursing facility. Some hospices have their own inpatient centers where they provide hospice care.