What Is Hospice?

Hospice is a collection of health care services designed to support a patient and family through the course of a terminal illness. The aim of hospice is to provide physical and emotional care and comfort in the months, weeks and days before death.

Hospice services typically involve care from a hospice team that includes a physician, nurse, medical social worker, and nutritional, pastoral and other counselors. Hospice patients also may receive home health care services, medical supply deliveries and physical, occupational and speech-language therapy.

When Does Someone Need Hospice Care?

Making the decision to use hospice care typically occurs after a physician informs a patient or their caregivers that more aggressive treatments are unlikely to prolong life and may even make remaining days more difficult. A doctor may suggest to families that the extra care offered by hospice may alleviate pain and provide much-needed support with daily challenges.

Where Do People Get Hospice Care?

Hospice care can be provided at home, in assisted living facilities and nursing homes and in some hospitals or in stand-alone hospice facilities. Home hospice offers the advantages of being in a familiar environment during a stressful time while hospice facilities can offer round-the-clock care support and sometimes quicker access to medical equipment.

What Do Hospice Nurses Do at a Home Visit?

With home hospice care, patients receive weekly or more frequent visits from a nurse and other members of the hospice team, but caregivers still provide most of the care.

Here are some of the activities a hospice nurse performs during typical home-based care:

  • Greet patient and caregiver(s); the nurse may offer support to the patient and caregivers privately during the course of the visit.
  • Ask about appetite, energy levels and whether patient is experiencing pain or symptoms.
  • Take patient’s blood pressure level, heart rate, weight, and other vital signs.
  • Ask if medications seem to be helping or if they are causing problems.
  • Assist patient and caregiver in obtaining medical supplies or equipment needed at home.
  • Offer advice to caregiver and patient about what to expect next in disease process and when/how to request for special assistance.
  • Listen to patient’s and caregiver’s emotional concerns and suggest/arrange assistance from a social worker or pastoral care.

How Is Hospice Care Paid For?

Medicare is the primary payer for more than three-quarters of hospice patients. For patients who qualify for Medicare, the Medicare hospice benefit pays for home and inpatient care and services not normally covered. At little or no additional cost, patients receive care from nurses, doctors, and other members of the hospice team, as well as supplies like walkers and medical beds. Most employer or private health insurance plans also include a hospice-care benefit, although they may pay primarily for home care and services and offer limited coverage for inpatient care. It is best to check with your health plan to get specifics of hospice coverage.

Want More Information on Hospice Care?

  • Hospice Net is a non-profit organization that provides information about finding hospice care and a variety of information and resources on coping with a life-threatening illness.
  • The Visiting Nurse Associations of America (VNAA) is a national association that supports, promotes and advocates for community-based, nonprofit home health and hospice providers that care for all individuals regardless of complexity of condition or ability to pay.
  • The Home Care/Hospice Agency Locator contains the most comprehensive database of more than 20,000 home care and hospice agencies.
  • HospiceDirectory.org is a comprehensive and user-friendly directory of hospices, their phone numbers and locations, and complete information about their services.
  • Eldercare Locator, a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.
  • The National Cancer Institute has created a fact sheet on hospice with resources and information.
  • The Alzheimer's Association published a free online resource, "Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities." It is a 21-page booklet that offers information about Alzheimer's disease and related dementia, specifically care issues related to late and final stages.

Resources reviewed June 2013

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Choosing a Nursing Home
Selecting a nursing home for a family member can be a challenging process. Here are some private and governmental resources to help you compare homes and learn about their services.
Making Plans for Your End-of-Life Health Care
Advice for having conversations about your end-of-life care and tips and online resources for creating an advance directive.
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Hospice care can provide extra support for people near the end-of-life and their families. Here’s advice on how to find hospice care, including online directories and advice for paying for this valuable service.
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