Hospice care is something that almost everyone will have to deal with at some point, either personally or for a loved one.Hospice refers to end-of-life care that focuses on comfort and pain management for people with less than six months to live.There is a greater variation in quality of care due to the fact that there are more hospice options.By planning ahead, doing your homework, and asking the right questions, you can help to ensure that your loved one receives appropriate and compassionate end-of-life care.
Step 1: Start planning early.
Hospice care isn't one of life's certainties like "death and taxes", but it is becoming an increasingly common element of the end-of-life experience.We all know the end will come eventually, so look past the unpleasantness of planning for death and prepare ahead of time in order to ensure the best care possible.Discuss end-of-life care with a loved one.If a serious illness leads toHospice care, begin looking into options in your area.You can talk to physicians, insurers, community organizations, friends and co-workers.Before the emotional turmoil of an end-of-life situation begins, the better if you gather more information.If one is diagnosed with a chronic illness that can't be cured, but can be managed with medical treatments, there are programs that bridge the gap.If the person's life expectancy is longer than six months, but the condition requires certain care to help manage the illness, then this is a good option.
Step 2: As a savvy consumer, shop around.
Hospice care in its modern form has only existed for about half a century, but the options have grown significantly in recent years as it has become a recognized component of the continuum of care.Hospice care has become a profitable industry since it used to be a realm of charities and mom-and-pop operations.Hospice and Palliative care programs are available at many hospitals and health centers.Do not assume you don't have a choice if you accept a Hospice recommendation.It is important that you find a good fit for Hospice.Hospice is a service that involves a delicate time in one's life and the "fit" between providers has to ensure that when the patient dies, her loved ones will be guided into the process that must be completed afterwards.You don't need to be pushed into choosing a hospice service.
Step 3: Take care of your medical providers.
When it's time to seek hospice care, your physician and other healthcare providers should play an important role.Before you can be eligible for Hospice care, you need a terminal diagnosis.Your healthcare providers can often give you guidance on the types of settings and care options that are right for you.In the U.S., your medical insurance provider and/or Medicare will play important roles in the process.Hospice care is covered by Medicare and most insurance plans, but there are restrictions and hoops to jump through.The choice should be yours as long as your options meet the criteria.Hospice services are usually recommended by the case management personnel and social workers.The sole responsibility is not on the family member or patient but on them.The true service of hospice was not utilized when the patient was referred just days prior to their death.By obtaining hospice care sooner rather than later, the family and patient can make the most of their time together, and ensure that the patient is pain free and comfortable in his last months.
Step 4: Determine what type of care you need.
Hospice care usually occurs in the terminal patient's home, with providers coming to the home to offer regular assistance and support for the patient and the primary caregiversHospice care has expanded beyond the home setting.If you needHospice care in a hospital, nursing home, or long-term care facility, look into providers that specialize in those settings.Specialty hospice care centers may be another option.If staying at home is a priority for you, look for providers that will respect and support that decision, as well as provide whatever assistance they can to make that happen.
Step 5: Take into account your preferences for size, distance, and affiliations.
Smaller hospice operations can often provide more personalized care, but larger operations have more staff, resources and technology.Don't assume any smaller or larger hospice service will meet your care preferences because there are always exceptions.Ask questions and investigate.Consider staff-to-patient ratios for small and large programs.Any single care provider should not have more than twelve patients at a time.Keep in mind the distance as well.The providers are far away.How long will it take them to get to your home when you need them?How far away is the hospice center if you will not stay at home?How long of a trip will it be for a loved one?Do you prefer aHospice provider that is affiliated with a specific religious organization, one that provides spiritual support that respects a wide range of belief systems, or neither of these?Consider what role religion/faith/spirituality will play in the final days, and how a hospice provider can support that preference.
Step 6: Be willing to change providers.
It's possible to do all your homework, listen to the best advice, and still find out that you made the wrong choice.You have the right to change your mind and choose a new provider, but it may take some extra work with your insurer to ensure continued coverage.The clock is running when it comes to hospice care, so don't wait to see if it improves.Ensure that you get as much end-of-life care as possible.
Step 7: Affirmative accreditation, certification, and licensure.
Some hospice providers have been around for a long time, while others disappear quickly.While longevity does not always equal superior quality, you are more likely to have a positive experience with a provider that has ample experience and has earned proper recognition for its services.Hospice providers that have earned accreditation by a national organization, certification by Medicare, and proper licensure should be your preference.
Step 8: Discuss with administrators and staff members.
Hospice care is dependent on personal relationships between caregivers and patients.Talk to the people in charge of the service and the ones who will provide the care.Make sure they are sincere about wanting to provide exceptional end-of-life care, and that they view the goals and process of care in a similar way to you.If you want to know more about that hospice provider, speak to the administrator.If applicable, get a tour of the facility.Get references from organizations that work with this provider.The experience, training, and certification of the staff should be asked.Every member of the staff that deals with a terminal patient should be certified in hospice care and have a solid combination of experience and training.Hospice providers should have certified staff on call 24 hours a day, seven days a week.Speak to the care providers.If you want to get a feel for the type of people that work for this hospice provider, conduct informal interviews.
Step 9: Discuss a care plan for the patient and family.
A care plan tailored to the individual patient is a standard element of any hospice care provider.The provider should be willing to work with you, your family, and members of the Hospice team to develop and implement the plan.A Hospice team can include your doctor, medical director, nurses, home healthcare workers, clergy, counselors, volunteers, and therapists.The family will often play a central role in the care of a terminal patient.The family is expected to provide care and support.If care is delivered in your home, this is even more true.Hospice personnel round on patients throughout the day, with family members often the main caregivers.If the patient passes away, or if the pain becomes uncontrollable, the hospice caregiver is on call.Ask about respite care, which allows primary caregivers to take a few days off from the mental and physical stress by placing the patient in temporary, full-time care.This can be done in the local hospital.If a family member needs a break, Hospice personnel can help.
Step 10: Discuss finances and get billing and payment terms written.
Hospice care is covered by Medicare and most private insurers in the U.S., but there may be insurance co-pays and deductibles to deal with, for instance with medications and respite care.Make sure you understand how the billing process works and what kind of arrangements can be made.As you work to determine what will be covered and how much of the cost is your responsibility, your insurer will have to be involved as well.The hospice provider should have a lot of experience in dealing with insurers.Should your circumstances dictate it, Hospice providers will usually accept private payments.All payment terms, conditions, and processes should be explained in writing.
Step 11: Emergency planning and treatment options are addressed.
The end of life doesn't always go according to planAsk if the provider will adapt to changing circumstances during the period of care.What alternatives are available if the patient can no longer stay at home?Does the provider have a hospital or care center?Is the hospice service willing and able to offer treatments like blood transfusions, supplemental oxygen, feeding tubes, emergency hospital visits, and even chemotherapy or radiation strictly for pain management and patient comfort?Do they understand and support the patient's advance directives?Is the hospice provider prepared to deal with power outages, severe weather, and other emergency situations?If you want to see their emergency plan, ask.
Step 12: Once death is imminent, determine their level of involvement.
You might think that hospice care will be there right up to the end, but that is not always the case.If you want hospice care and support right up to the moment of death, or if you prefer for them to back off at the very end, be clear about your expectations and ask about their policies.Postmortem services may be provided by some hospice providers.Ask about their end-of-life care policies, and be clear about your preferences and expectations.