What to Know About Hospice Care
- Angelic Health Palliative and Hospice Care
- Jul 21
- 5 min read
When talking about healthcare we often think of preventative medicine, treatment for illness or injury and working toward recovery. However, for those with a terminal diagnosis there is hospice care. This is a special type of healthcare focused solely on providing comfort when a cure is not an option for those expected to live six months or less. It is fully covered by Medicare, Medicaid and most insurances.
Hospice provides a team approach to the care of the patient wherever they live and supports their loved ones. The team includes a nurse, aide, social worker, spiritual care and bereavement counselors. Volunteers are also part of the team, providing friendly visitors for patients. They work collaboratively to manage the patient’s symptoms and support their quality of life.
Heather Hernon, the business development manager at Angelic Health, has worked in the hospice for two decades and shared the answers to the most asked questions about hospice.
How soon will hospice services start?
Typically begins very quickly after referral. Usually within 24 to 48 hours and sometimes even sooner, same day, in urgent situations Once we speak with the family and all information for the referral is received, our goal is to get out to the patient and family as soon as possible. During the evaluation, RN/ case manager will review hospice philosophy, hospice diagnosis, medication profile, education on disease process, answers any questions, have consent for care signed, discuss schedule for the hospice home health aide as well as for the RN/ case manager, social worker and chaplain. All equipment, supplies, and medications needed for patient care and comfort in the home will be ordered.
Who will be seeing the patient?
I usually tell families that it’s the “Calvary of Care” that comes out to see and care for not just their loved one, but for themselves as well. The hospice care team consists of an RN/ case manager who coordinates care plan and collaborates with our medical director and/or patient's primary care physician. The RN/ case manager also oversees the care team, symptom management along with medication management, education and guidance on disease process. The nurse usually sees the patient once or twice a week but can be more often dependent on the patient’s needs.
Patients will have a home health aide (HHA) who assists with all personal care, such as bathing, showering, grooming, etc. Health aides may be seeing the patient anywhere from five to seven days a week depending on the patient’s need and in coordination with the RN/case manager.
Another vital team member is the social worker who provides emotional counseling grief support, but they can also assist with end-of-life planning such as POLST or advanced directive, etc. They’re also able to connect patients and family to other community resources and they're usually out of the home once or twice a month again if needed can be out there more often.
The spiritual care counselor or chaplain addresses the spiritual support emotional needs of the patient and the family regardless of faith. They usually visit once or twice a month but may go more often if needed.
Hospice volunteers offer additional companionship to the patient with visits scheduled once or twice a month. They may also provide a respite for the family, spending time with the patient and allowing the caregiver to step out to address their own needs.
The bereavement coordinator supports the family following the loss of their loved one for 13 months but can also be longer if needed.
These team members are your daytime team. We also offer Triage Team after-hour nights, weekends and holidays. Each team member, except for the hospice home health aide, is with patients and family for however long they need to be there assisting with patient needs. Hospice home health aides (HHA) are available for up to two hours.
Do not hesitate to call at any time you need help.
How long will services last?
Angelic is by your side however long we need to be there. Under Medicare guidelines, patients receive two initial 90-day periods each requiring recertification of a life expectancy of six months or less. That's then followed by an unlimited 60-day period with recertification. After the first 180 days care continues in six week blocks as long as patients continue to show decline and remain eligible through
Medicare guidelines allow hospice care to last longer than six months. In some cases, it could be a year or more except for five years or longer. Hospices are unlimited as long as patient continues to qualify for hospice. If the patient’s condition improves, they can be graduated off of services. However, if they their condition declines at a later date, they can be readmitted to hospice services. If a patient at any time decides they want to pursue curative treatments, they can come off of services to pursue those treatments. As long as they qualify, they can be readmitted to hospice.
Do I have to accept all the services?
Patients and/or family can accept or refuse any service. However, they must have a visit from the RN/case manager at least every other week. Frequency of team member visits typically is based on the needs of the patient.
Are services available on the weekend, holidays, evenings?
Yes, Angelic has a full triage team ready to serve patient needs nights weekends holidays.
Can I have a home health aide (HHA) every day?
Yes, has can provide a HHA anywhere from one day a week to seven days a week. Again, it all depends on patient needs. Once home health aide schedule is established. It is the same HHA at the same time for every visit. Ensuring trust and continuous care between the patient and HHA as well as the rest of the care team.
Can I still see my doctor?
Yes, patients can continue to see their primary care physician. If their primary care physician remains involved during the hospice process, their physician must agree to become the attending physician and will collaborate with the hospice care team. If primary care, physician declines to be involved, then the hospice medical director assumes the attending role.
How much does hospice care cost?
Hospice care is provided without cost to patients through Medicare A, Medicaid and most private insurance benefits. Medications, supplies, equipment, and all team member visits are all covered at 100% through Medicare A.
Is hospice care only for the last days of life?
Hospice is most beneficial when there is adequate time to manage symptoms, establish communication and relationships with team members and provide education to both patient and family about exactly how hospice can add days to their life. Families tell us their biggest regret was not starting hospice care sooner.
Is cancer the only diagnosis for hospice?
Hospice care is provided for anyone with a life limiting diagnosis with a life expectancy of six months or less. Common diagnosis include cancer in addition to Alzheimer's disease, cardiac, and renal disease.
Where is hospice care provided?
Hospice is provided whoever a patient calls home. That could be their private residence, it could be in an independent living community, assisted living community or skilled nursing center.
Must you sign a DNR to receive hospice?
This is a myth. A DNR (do not resuscitate) is not a requirement to receive hospice services. The only requirement is that patients qualify.
Angelic Health staff are available to talk with you about hospice care and answer your questions. Visit our website www.angelic.health to learn more and for contact information for an office near you.
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