What is Hospice Care at Home?
Hospice Care: What You Need to Know
Hospice care is appropriate when a patient seeks “comfort care” and is no longer interested in curative therapies (i.e., rehabilitation). Many people choose hospice care services when they are nearing the end of their lives due to a chronic condition or disease.
Hospice care at home provides respite care for family caregivers and sends members of the hospice team to a patient’s home to ensure they are receiving quality care during their final months, weeks, or days of life.
The hospice care team is not there around the clock, and family members generally take on some of the care responsibilities. However, hospice workers come into the home often and take care of many things family members may be unable to or do not understand. The respite care that can come from hospice care services also helps family caregivers get time for self-care, running errands, and other tasks they need to do while caring for a loved one.
You may have been asked about hospice care if you have a loved one with a terminal illness, especially if you are their primary caregiver. If you are unsure about this option or not clear on everything it can provide, it is essential to get answers to your questions before deciding on the care your loved one will receive in their final stage of life.
Here’s what to know about hospice benefits for at-home care so you can decide whether it is a better choice than a hospital, nursing home, or other facility providing end-of-life support.
Hospice Care: What You Need to Know
The healthcare community is making a concerted effort to educate patients, their healthcare agents, and families about the Medicare Hospice Benefit (MHB) so they can make an informed care decision that meets the wishes of the patient or loved one in senior care.
That is good news for patients and family members because it helps them consider their options and understand the care they can receive. Because hospice care can be such a vital part of the support services available when a loved one is dying, knowing how to use it to its fullest matters.
Ongoing Support in Many Areas
Patients who qualify for hospice care services often need pain and symptom control, but they may also need additional care services and help with bathing, dressing, taking medications, and more. With support from family and the hospice team, more patients can get quality care even when a serious illness is moving the patient into their last days.
Insurance Benefits and Hospice Coverage
Too many Medicare recipients and their family members do not know that hospice care at home may be a covered service. They mistakenly think that a nursing home or hospital is the only option for someone who needs hospice benefits.
When loved ones can get hospice services at home, though, they can pass away somewhere familiar and comfortable. This can help families and patients have more peace, and the hospice care team will work with the patient and their families to make the end-of-life transition as easy as possible. While hospice care at home is not as controlled of an environment as a hospital or nursing home, many patients have the option of choosing it for their needs.
What Are the Benefits of Hospice Care at Home?
At-home hospice care has some significant benefits. For example, the hospice team is a specially trained group of medical care professionals, including doctors, nurses or nurse practitioners, pharmacists, physical & occupational therapists, speech-language pathologists, social workers, counselors, chaplains, hospice aides, and volunteers.
Whole Person Care for Comfort and Peace of Mind
Hospice care teams provide care for the “whole person,” including physical, social, emotional and spiritual needs. The hospice program is more than just medical care in the strictest sense; it understands that hospice patients need more than a hospital bed and pain management.
Patients may also want spiritual support, a social worker, physical therapists, and others who can make their journey easier.
A Wide Range of Services and Options
Typical hospice services include physical care, short-term inpatient care (pain and symptom management), short-term respite for the primary caregiver (up to 5 days), grief, loss and dietary counseling, medications, durable medical equipment (DME), such as hospital beds, wheelchairs or walkers, oxygen, and supplies (i.e., incontinence).
Insurance Coverage for Hospice Care
These benefits must follow Medicare guidelines if the patient is using Medicare. There are also Medicaid insurance plans and other insurance coverage options that may provide health care at home, including palliative care and hospice care. Being at home instead of in an inpatient setting can help improve the quality of life in a patient’s remaining days and give them more time with friends and family.
Types of Hospice Care
Palliative care and hospice are not the same, but they often exist alongside one another. Additionally, someone receiving palliative care, which is designed to keep them comfortable and manage pain and other issues, may move to hospice care as their condition takes its natural course.
Symptom relief can be managed by a palliative care organization or a hospice care team, depending on where the patient is in the progression of their condition.
Options for Passing Away at Home
Hospice care at home is somewhat different from care in a facility such as a nursing home. Still, registered nurses and other hospice care professionals work with the patient in both settings.
Medical supplies, emotional support, and a variety of other helpful options are provided whether the patient is in an assisted living community, the hospital, or at home.
The biggest difference is that a hospital setting may offer more monitoring for the patient, but medical treatment to prolong life is typically not part of hospice care.
Instead, the goal is to allow the patient to pass away as naturally and comfortably as possible, and many patients with serious illnesses want that to happen in their own homes.
Quality of Life for as Long as Possible
End-of-life care is the goal of hospice services regardless of where the patient is located. Even for patients who do not have a lot of time left, quality of life still matters.
Having professional caregivers and family members helping them on their journey can make the end of a patient’s life calmer and more peaceful.
Pain management is provided with in-home hospice care, as is personal care for the patient and bereavement counseling for the family.
How is Hospice Care Paid For?
Private insurance may pay for some home health services and cover hospice care, but the majority of the patients who need this kind of care are on Medicare. For those patients, eligibility for the hospice benefit includes:
- Having Medicare Part A (hospital insurance).
- Having a primary care physician (PCP) or nurse practitioner (NP) and hospice physician certify a terminal illness with six months or less to live.
- Ensuring the patient or their agent accepts palliative care for comfort instead of care to cure the illness.
- Having the patient or their agent sign a statement choosing hospice over other Medicare options.
All these steps must be taken before Medicare covers hospice services, but the forms do not take long, and a social worker typically talks to the family and patient about their options.
Private insurance may have different regulations based on how they cover a palliative care team or hospice services.
For patients with Medicare, the hospice benefit does not cover:
- Any treatments intended to cure a terminal illness.
- Prescription drugs (except for pain and symptom management).
- Care from any provider not set up by the selected hospice agency.
- Room and board (i.e., assisted living).
- Hospital-level care, such as emergency department visits, inpatient care or ambulance transportation (unless arranged by your hospice provider).
Hospice care focuses on comfort and peace of mind when a health care provider thinks a patient will live another six months or less and the patient and/or family responsible for that patient agree. When agreeing to hospice care, medical attempts to lengthen life or cure a disease or condition end.
How to Access Hospice Care
The first step to exploring the hospice option is to request a one-time hospice consultation with a Medicare-approved hospice provider.
Hospitals usually provide a list of local hospice agencies for families to choose from. Depending on the location, there may be multiple agencies to consider, while smaller or more rural areas tend to have fewer hospice providers.
If the patient, agent, or family decides that hospice is the right care option and eligibility is confirmed, the hospice agency will coordinate a plan of care following discharge from the hospital to a hospice inpatient facility, the patient’s home, or long-term care facility (assisted living).
Medicaid services may also be used at this time, depending on the patient’s care needs and other factors.
Benefit Periods Keep Hospice Care Available
Hospice care is provided in benefit periods. If a patient lives beyond six months, they can continue under hospice care if the hospice medical director re-certifies the terminal illness. More specifically, hospice care is approved initially for two 90-day benefit periods followed by an unlimited number of 60-day benefit periods.
It’s important to know that a patient or their agent can change the hospice provider once during a given benefit period or choose to stop hospice care at any time. Having those options and understanding how to exercise patient rights is extremely important to get the best quality of care from a hospice organization.
Is Hospice Care at Home Right for Your Loved One?
Overall, hospice care is a wonderful benefit if your loved one wishes to be comfortable in their final season of life.
Whether they’re at home or in an assisted living facility, hospice can help. Many patients want to be at home during their last days, and having hospice care at home can make that easier for them and their family caregivers.
If you are not sure what your loved one might want, having a conversation about it can be very important. Then, you know you are following their wishes and helping them get the care they need as they age. By choosing in-home hospice care, you can provide your loved one with a way to have comfort and peace during their last journey.
How CarePatrol Helps Families and Older Adults
Hospice comes near the end of life for older adults, but until that time comes, it’s critical to ensure they have the best living environment for them.
That’s how CarePatrol helps. Our senior care advisors help families find senior care options and match them with the options that meet their needs —at no cost to you! To get started, find a local CarePatrol Senior Care Advisor and get the help you deserve.