Hospice Basics

A look at the members and goals of a typical hospice care team, as well as information on hospice patients and ways to pay for hospice care.

Hospice care provides reasonable and necessary medical and support services to individuals with a terminal illness. It focuses on treating the symptoms of a disease rather than the disease itself, while attempting to help the care recipient maintain the highest possible quality of life possible during his or her final months.

Hospice care is usually provided by a team of individuals that includes:

  • A bereavement team
  • A doctor
  • Caregivers and other family members
  • Case management workers
  • Children’s specialists (to help children cope with a loved one’s illness)
  • Home health aides
  • Registered nurses
  • Social workers
  • Spiritual caregivers
  • Volunteers

Volunteers are one of the most important parts of a hospice team. While their services may vary, volunteers typically donate 2-5 hours a week to help the hospice team with:

  • Administrative tasks
  • Memorial services
  • Bereavement training
  • Fund raising activities (to help care recipients who can’t afford hospice services)
  • Giving hands-on care to the care recipient
  • Offering respite and support to caregivers and family members
  • Transportation for the care recipient

The hospice team works together to come up with an individual program for the care recipient. In addition to assisting with personal care needs and providing respite care for caregivers, hospice programs offer care that is:

  • Available 24 hours a day, 7 days week
  • Educational for the patient and family
  • Focused on helping care recipient remain as mentally and physically active as possible
  • Focused on managing the care recipient’s pain
  • Inclusive of bereavement support for family members (e.g., educational and social events, phone contacts, support groups)
  • Based on the care recipient’s needs
  • Supportive of caregivers (e.g., counseling, support groups)

Specific hospice programs also usually have goals, which may include:

  • Attending to the physical and mental suffering of the care recipient
  • Continuing to treat the care recipient until his or her death, and helping his or her family for 12 months following the death
  • Focusing on the dignity and goals of the care recipient
  • Honoring the care recipient’s preference for withholding or withdrawing life-sustaining intervention
  • Planning for the end-of-life care

Hospice care is normally given in one of three types of facilities, including the care recipient’s home, an institutional facility for hospice care (within assisted living facilities, hospitals, or nursing homes), or residential hospice facilities. Approximately 85 percent of hospice patients receive care at home, and many of these individuals choose to spend their last months in hospice so that they can die in a comfortable setting. Residential hospice facilities are normally used only when:

  • Adult children are working full time or don’t live locally
  • Care is too medically technical for a layperson to perform
  • The caregiver is unable to provide round-the-clock care
  • The home is not suitable and can’t be adapted
  • 24 hour-a-day nursing care is needed

Who Are Hospice Patients?

The majority if hospice patients have cancer, although any individual with a terminal illness who has fewer than 6 months left to live may make use of hospice services. Generally, hospice care is appropriate for individuals who:

  • Have difficulty managing activities of daily living
  • Have a terminal illness
  • Wish to focus on symptom management—including pain management—rather than treatment of the disease

How Is Hospice Care Paid For?

Medicare covers hospice services, but you should make sure that the hospice service that you are interested in is Medicare certified. If it is, it will be certified by the Health Care Financing Administration (HCFA). In addition, approximately 40 states and the District of Columbia offer hospice coverage under Medicaid. Many private HMOs and other insurance companies also offer partial or total hospice coverage, so you should check into your loved one’s benefits plan.

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