What is hospice care?
Below, you will find a number of resources for anyone who may be new to the idea of hospice care. First we will break down the four primary levels of hospice care, giving you a solid understanding of what type of care hospice entails. Finally, this page is dedicated to a number of resources for both hospice patients and their families when it comes to understanding financial and medical manners.
The Four Levels of Hospice Care
Routine Home Care
Routine Home Care is provided in a patient's residence, which may be a private home or facility. Hospice services follow an individualized plan of care that describes the needs, frequency and intensity of care required.
General Inpatient Care
General Inpatient Care is short-term acute care delivered in a hospital, inpatient unit, or skilled nursing facility when a patient’s symptoms cannot be adequately managed at home. It is not intended for long-term custodial care.
Respite Inpatient Care
Respite Inpatient Care provides short-term relief to a patient’s primary caregivers by transferring the patient to a hospice inpatient unit, hospital or skilled nursing facility for up to five days.
Continuous Home Care
Continuous Home Care is delivered in a residential setting when the patient is in crisis and symptoms cannot be managed at the “routine home care” level. May be initiated to prevent transfer to an inpatient setting.
Hospice care is designed to be palliative - meaning that its' primary focus is to alleviate pain and relieve symptoms. Our hospice experts strive to keep our patients comfortable while helping them and their circle of support make the most out of the time that is left.
Things You Should Know
-
Specialized Care for life expectancy measured in months, not years.
The earlier our care plan can be established, and our team of experts can begin their work, the more comfort we can provide. Our team aims to begin their work when a patient has received a prognosis of six months or less. Hospice is not just for the final days of life.
-
Hospice is not a place; it's a philosophy of care.
Patients can be cared for in their homes, nursing homes, or, for shorter periods of time, in a hospice inpatient unit or contracted facility. The desires and needs of the patient determine the care setting.
-
Hospice is 100% covered by Medicare for eligible patients.
For certain eligible patients, Hospice care may be entirely free via Medicare. You can learn more here.
Hospice & Medicare: A Guide to Benefits
Coverage In General
-
Hospice is available as a benefit under Medicare Part A.
For those patients of ours that are currently under the provider-ship of Medicare, you are covered under Medicare Part A. Click Here to read more about what Medicare Part A entails, and your coverage under it.
-
Most HMO's and private insurers offer a similar benefit.
If you are utilizing an HMO or a private insurer, you may have coverage options similar to Medicare, providing you meet the relevant requirements. Contact Us today and our team will help you determine your eligibility with your insurance provider.
-
Care unrelated to a hospice diagnosis is covered as usual.
Whether a patient is covered under an HMO, a private insurer, or through Medicare, their care unrelated to their hospice-specific diagnosis will be covered and billed as is normal for whatever server you are with.
Covered Services
Benefits include all reasonable and necessary medical support services for the management of a terminal illness, including:
-
Hospice Physician Services
-
Nursing Services
-
Hospice Aides
-
Medical Social Services
-
Short-term Inpatient Care
-
Caregiver Respite Care
-
Spiritual Counseling
-
Volunteer Serivces
-
Bereavement Support
-
Dietary Counseling
-
Medication
-
Durable Medical Equipment
Equipment, Oxygen, and Medication
The Medicare hospice benefit covers equipment rentals that help increase comfort for hospice patients and make it easier for caregivers to give comfort. If a hospital bed, bedside commode, air mattress, wheelchair, or portable oxygen supply is necessary, it will be provided.
Prescribed medications to relieve pain and manage symptoms are usually also covered by the Medicare hospice benefit. All medications must be ordered by our staff from a pharmacy within our contractual network.
Your hospice benefit is paid by Medicare Part A. Hospice is responsible for covering the cost of all medications related to your terminal illness and any related conditions. For these related medications, Medicare allows the hospice to charge a fee equal to 5% of the drug cost with a maximum charge of $5.00 per medication.
For those patients with Medicare Part D coverage, your pharmacy must bill all medications to the hospice provider to determine whether they are covered under the hospice benefit or Part D plan.
You may also have Medicare Part D coverage that has been paying for some of your medications. Now that you have chosen to enroll in the Medicare Hospice Benefit, the plan of care will include information about who will pay for which of the medications that you choose to continue.
Some of your medications may not be related to your terminal illness. These medications will not be paid for by hospice. In this event, hospice communicates with the Part D Sponsor, so that Part D will continue to pay for these medications. You will continue to receive these medications from your pharmacy in the same manner as you did before enrolling in hospice.
You may be taking medications that have an effective and comparable substitute for the hospice benefit to cover the cost. If you do not agree with the change to a comparable drug, you may elect to continue your current medication and be responsible for the cost of the medication.
During the course of your care, some of your medications may no longer be beneficial. When this occurs, the hospice team will explain the benefits and risks of discontinuing such medications, so that you can make the best decision for you.
Medications are one important part of the patient plan of care. The hospice team is committed to providing you the very best service by responding to your questions related to medications. Please reach out to your hospice nurse to make certain you have the information you need. Hospice is not in a position to advise whether a patient should maintain Part D coverage while receiving Medicare hospice services. It is the responsibility of the patient to pay Part D premiums, as desired.
Benefits Period
-
Medicare will pay for two 90-day benefit periods of hospice care, followed by as many 60-day benefit periods as may be appropriate.
-
For each period of care, even if it follows in consecutive order, the hospice physician must certify that the patient is eligible for hospice with a limited life expectancy.
-
A patient may elect hospice care, later revoke it and resume traditional medical care under traditional Medicare benefits.
-
A person who has revoked hospice care can easily resume it later if he or she is deemed eligible by our hospice physician.
-
If your condition improves or you no longer meet eligibility for hospice care, you will be discharged from the hospice benefit. The hospice team will work with you to coordinate your care back to your community provider.
-
We will continue to follow up with you to address any questions, provide resources and assess for any changes to your condition that would make you re-eligible for hospice services.
Guidelines for Hospice Care
For patients and their families who choose to undergo hospice care within their own home, a number of precautions and preperations can be made in order to keep your patient safe. There are countless everyday objects and actions that can result in complications for all parties involved if a little bit of thought is not put into these things.
- Use proper lifting techniques and turning methods to reduce the risk of injury.
- Develop an emergency plan.
- Have someone check on you daily if you live alone.
- Keep the phone and emergency numbers within reach.
- Keep cords and outlets in good working condition.
- Keep extension cords out of walkways.
- Do not place extension cords under carpets.
- Install hand rails in tub and near toilets if needed.
- Keep hot water at a safe temperature to prevent burns.
- Use a shower chair or non-skid bath mat to avoid slipping.
- Use smoke detectors on each level of your home and outside bedrooms.
- Test smoke detectors monthly.
- Do not smoke around oxygen.
- Have an escape plan.
- Remove throw rugs.
- Wipe up spills as soon as possible.
- Use a walker or wheelchair as needed.
- Use night lights.
- Have a flashlight available.
The Medicare hospice benefit covers equipment rentals that help increase comfort for hospice patients and make it easier for caregivers to give comfort. If a hospital bed, bedside commode, air mattress, wheelchair, or portable oxygen supply is necessary, it will be provided.
During the course of your care, some of your medications may no longer be beneficial. When this occurs, the hospice team will explain the benefits and risks of discontinuing such medications, so that you can make the best decision for you.
Breathing patterns can change as a result of an underlying disease process; a reaction to a medication or infection; anxiety or fear; or as a natural part of the dying process.
- Change positions. Elevate the bed or use pillows to prop the upper body. Sit up and lean forward.
- Medications. Take prescribed medications and utilize oxygen, if ordered.
- Change the environment. Create a calm, quiet room; use a fan to circulate air; or use a humidifier or vaporizer.
- Conserve energy. Eat slowly and rest frequently; plan periods of rest throughout the day; discuss pursed-lip and abdominal breathing with your hospice nurse.
- Utilize relaxation techniques such as calming music, meditation, visualization or imagery, or the presence of a family member or pet.
You may see a change in the desire to eat. It is common to not feel hungry and to require less intake than you did previously. In the later phase of illness, forcing food or drink may result in physical or emotional distress and have little impact on extending life expectancy.
- Eat as little or as much as wanted.
- Try eating small, more frequent meals/snacks.
- Offer foods with increased nutritional value and higher calories, without increasing the quantity.
- Serve food cold or at room temperature to decrease foodrelated odors.
- Offer ice chips, popsicles and frequent mouth care for comfort.
- Avoid forcing the patient to eat or allowing appetite to become the focus of care.
Everyone experiences different feelings at the end of life. The most common concerns are fear of abandonment and fear of being a burden. People at the end of life also have concerns about loss of dignity and loss of control.
- Keep the person company. Talk, watch movies, read or just be present.
- Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Prepare to listen.
- Reminisce about the person’s life experiences.
- Avoid withholding difficult information. Most people want to be included in discussions about issues that concern them.
- Ask if there is anything you can do.
- Respect the person’s need for privacy.
- Support the person’s spirituality. Let them talk about what has meaning for them, pray with them if they request, and arrange visits by spiritual leaders and church members, if appropriate.
- Patients with serious, life-limiting illness have stated that being positive or adding humor remains an important outlet to them. Even when it feels most challenging, laughter may still be the best medicine.
It is just as important for caregivers to take care of their own health at this time. Taking care of a sick person can cause physical and emotional fatigue, stress, depression and anxiety.
- I have the right to take care of myself. This is not selfish. It makes me a better caregiver. I do a lot for this person. I can do things just for myself.
- I have the right to make a life for myself. I know there may come a time when my loved one no longer needs my fulltime help.
- I have the right to get help from others even if my loved one doesn’t want me to. I know there are limits to what I can do alone.
- I have the right to get angry, be depressed and express all feelings.
- I have the right to not be controlled by my loved one through guilt.
- I have the right to receive respect, love, forgiveness and acceptance from my loved one for what I do. I will offer these things in return.
- I have the right to give myself credit for all that I do. It takes courage to be a caregiver.
- Maintain contact with supportive friends and family.
- Rest and sleep as needed.
- Take a break from caregiving when you are able.
- Exercise as able.
- Eat several times daily.
- Find a way to relax (watch a movie, read a book, listen to music).
- Talk to others about your feelings or join a support group
Ready to continue?
If you feel Hospice and / or Palliative care is the right solution for you and your family, then we are here to help you take your first steps! Click below to either learn more about what Agave can specifically do for you, or contact us today so we can start giving you the time you need with the ones you love.
Who is Agave?
Learn about what the Agave family and our team of caring experts can do for you and your loved ones during your time with Hospice.
Get In Touch
Ready to move forward? Have more questions about what Hospice is or what Agave can provide for you and your loved ones? Get in touch today!
Quick Access
Agave Contact Info
Call
What is hospice care?
Below, you will find a number of resources for anyone who may be new to the idea of hospice care. First we will break down the four primary levels of hospice care, giving you a solid understanding of what type of care hospice entails. Finally, this page is dedicated to a number of resources for both hospice patients and their families when it comes to understanding financial and medical manners.
The Four Levels of Hospice Care
Routine Home Care
Routine Home Care is provided in a patient's residence, which may be a private home or facility. Hospice services follow an individualized plan of care that describes the needs, frequency and intensity of care required.
General Inpatient Care
General Inpatient Care is short-term acute care delivered in a hospital, inpatient unit, or skilled nursing facility when a patient’s symptoms cannot be adequately managed at home. It is not intended for long-term custodial care.
Respite Inpatient Care
Respite Inpatient Care provides short-term relief to a patient’s primary caregivers by transferring the patient to a hospice inpatient unit, hospital or skilled nursing facility for up to five days.
Continuous Home Care
Continuous Home Care is delivered in a residential setting when the patient is in crisis and symptoms cannot be managed at the “routine home care” level. May be initiated to prevent transfer to an inpatient setting.
Hospice care is designed to be palliative - meaning that its' primary focus is to alleviate pain and relieve symptoms. Our hospice experts strive to keep our patients comfortable while helping them and their circle of support make the most out of the time that is left.
Things You Should Know
-
Specialized Care for life expectancy measured in months, not years.
The earlier our care plan can be established, and our team of experts can begin their work, the more comfort we can provide. Our team aims to begin their work when a patient has received a prognosis of six months or less. Hospice is not just for the final days of life.
-
Hospice is not a place; it's a philosophy of care.
Patients can be cared for in their homes, nursing homes, or, for shorter periods of time, in a hospice inpatient unit or contracted facility. The desires and needs of the patient determine the care setting.
-
Hospice is 100% covered by Medicare for eligible patients.
For certain eligible patients, Hospice care may be entirely free via Medicare. You can learn more here.
Hospice & Medicare: A Guide to Benefits
Coverage In General
-
Hospice is available as a benefit under Medicare Part A.
For those patients of ours that are currently under the provider-ship of Medicare, you are covered under Medicare Part A. Click Here to read more about what Medicare Part A entails, and your coverage under it.
-
Most HMO's and private insurers offer a similar benefit.
If you are utilizing an HMO or a private insurer, you may have coverage options similar to Medicare, providing you meet the relevant requirements. Contact Us today and our team will help you determine your eligibility with your insurance provider.
-
Care unrelated to a hospice diagnosis is covered as usual.
Whether a patient is covered under an HMO, a private insurer, or through Medicare, their care unrelated to their hospice-specific diagnosis will be covered and billed as is normal for whatever server you are with.
Covered Services
Benefits include all reasonable and necessary medical support services for the management of a terminal illness, including:
-
Hospice Physician Services
-
Nursing Services
-
Hospice Aides
-
Medical Social Services
-
Short-term Inpatient Care
-
Caregiver Respite Care
-
Spiritual Counseling
-
Volunteer Serivces
-
Bereavement Support
-
Dietary Counseling
-
Medication
-
Durable Medical Equipment
Equipment, Oxygen, and Medication
The Medicare hospice benefit covers equipment rentals that help increase comfort for hospice patients and make it easier for caregivers to give comfort. If a hospital bed, bedside commode, air mattress, wheelchair, or portable oxygen supply is necessary, it will be provided.
Prescribed medications to relieve pain and manage symptoms are usually also covered by the Medicare hospice benefit. All medications must be ordered by our staff from a pharmacy within our contractual network.
Your hospice benefit is paid by Medicare Part A. Hospice is responsible for covering the cost of all medications related to your terminal illness and any related conditions. For these related medications, Medicare allows the hospice to charge a fee equal to 5% of the drug cost with a maximum charge of $5.00 per medication.
For those patients with Medicare Part D coverage, your pharmacy must bill all medications to the hospice provider to determine whether they are covered under the hospice benefit or Part D plan.
You may also have Medicare Part D coverage that has been paying for some of your medications. Now that you have chosen to enroll in the Medicare Hospice Benefit, the plan of care will include information about who will pay for which of the medications that you choose to continue.
Some of your medications may not be related to your terminal illness. These medications will not be paid for by hospice. In this event, hospice communicates with the Part D Sponsor, so that Part D will continue to pay for these medications. You will continue to receive these medications from your pharmacy in the same manner as you did before enrolling in hospice.
You may be taking medications that have an effective and comparable substitute for the hospice benefit to cover the cost. If you do not agree with the change to a comparable drug, you may elect to continue your current medication and be responsible for the cost of the medication.
During the course of your care, some of your medications may no longer be beneficial. When this occurs, the hospice team will explain the benefits and risks of discontinuing such medications, so that you can make the best decision for you.
Medications are one important part of the patient plan of care. The hospice team is committed to providing you the very best service by responding to your questions related to medications. Please reach out to your hospice nurse to make certain you have the information you need. Hospice is not in a position to advise whether a patient should maintain Part D coverage while receiving Medicare hospice services. It is the responsibility of the patient to pay Part D premiums, as desired.
Benefits Period
-
Medicare will pay for two 90-day benefit periods of hospice care, followed by as many 60-day benefit periods as may be appropriate.
-
For each period of care, even if it follows in consecutive order, the hospice physician must certify that the patient is eligible for hospice with a limited life expectancy.
-
A patient may elect hospice care, later revoke it and resume traditional medical care under traditional Medicare benefits.
-
A person who has revoked hospice care can easily resume it later if he or she is deemed eligible by our hospice physician.
-
If your condition improves or you no longer meet eligibility for hospice care, you will be discharged from the hospice benefit. The hospice team will work with you to coordinate your care back to your community provider.
-
We will continue to follow up with you to address any questions, provide resources and assess for any changes to your condition that would make you re-eligible for hospice services.
Guidelines for Hospice Care
For patients and their families who choose to undergo hospice care within their own home, a number of precautions and preperations can be made in order to keep your patient safe. There are countless everyday objects and actions that can result in complications for all parties involved if a little bit of thought is not put into these things.
- Use proper lifting techniques and turning methods to reduce the risk of injury.
- Develop an emergency plan.
- Have someone check on you daily if you live alone.
- Keep the phone and emergency numbers within reach.
- Keep cords and outlets in good working condition.
- Keep extension cords out of walkways.
- Do not place extension cords under carpets.
- Install hand rails in tub and near toilets if needed.
- Keep hot water at a safe temperature to prevent burns.
- Use a shower chair or non-skid bath mat to avoid slipping.
- Use smoke detectors on each level of your home and outside bedrooms.
- Test smoke detectors monthly.
- Do not smoke around oxygen.
- Have an escape plan.
- Remove throw rugs.
- Wipe up spills as soon as possible.
- Use a walker or wheelchair as needed.
- Use night lights.
- Have a flashlight available.
The Medicare hospice benefit covers equipment rentals that help increase comfort for hospice patients and make it easier for caregivers to give comfort. If a hospital bed, bedside commode, air mattress, wheelchair, or portable oxygen supply is necessary, it will be provided.
During the course of your care, some of your medications may no longer be beneficial. When this occurs, the hospice team will explain the benefits and risks of discontinuing such medications, so that you can make the best decision for you.
Breathing patterns can change as a result of an underlying disease process; a reaction to a medication or infection; anxiety or fear; or as a natural part of the dying process.
- Change positions. Elevate the bed or use pillows to prop the upper body. Sit up and lean forward.
- Medications. Take prescribed medications and utilize oxygen, if ordered.
- Change the environment. Create a calm, quiet room; use a fan to circulate air; or use a humidifier or vaporizer.
- Conserve energy. Eat slowly and rest frequently; plan periods of rest throughout the day; discuss pursed-lip and abdominal breathing with your hospice nurse.
- Utilize relaxation techniques such as calming music, meditation, visualization or imagery, or the presence of a family member or pet.
You may see a change in the desire to eat. It is common to not feel hungry and to require less intake than you did previously. In the later phase of illness, forcing food or drink may result in physical or emotional distress and have little impact on extending life expectancy.
- Eat as little or as much as wanted.
- Try eating small, more frequent meals/snacks.
- Offer foods with increased nutritional value and higher calories, without increasing the quantity.
- Serve food cold or at room temperature to decrease foodrelated odors.
- Offer ice chips, popsicles and frequent mouth care for comfort.
- Avoid forcing the patient to eat or allowing appetite to become the focus of care.
Everyone experiences different feelings at the end of life. The most common concerns are fear of abandonment and fear of being a burden. People at the end of life also have concerns about loss of dignity and loss of control.
- Keep the person company. Talk, watch movies, read or just be present.
- Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Prepare to listen.
- Reminisce about the person’s life experiences.
- Avoid withholding difficult information. Most people want to be included in discussions about issues that concern them.
- Ask if there is anything you can do.
- Respect the person’s need for privacy.
- Support the person’s spirituality. Let them talk about what has meaning for them, pray with them if they request, and arrange visits by spiritual leaders and church members, if appropriate.
- Patients with serious, life-limiting illness have stated that being positive or adding humor remains an important outlet to them. Even when it feels most challenging, laughter may still be the best medicine.
It is just as important for caregivers to take care of their own health at this time. Taking care of a sick person can cause physical and emotional fatigue, stress, depression and anxiety.
- I have the right to take care of myself. This is not selfish. It makes me a better caregiver. I do a lot for this person. I can do things just for myself.
- I have the right to make a life for myself. I know there may come a time when my loved one no longer needs my fulltime help.
- I have the right to get help from others even if my loved one doesn’t want me to. I know there are limits to what I can do alone.
- I have the right to get angry, be depressed and express all feelings.
- I have the right to not be controlled by my loved one through guilt.
- I have the right to receive respect, love, forgiveness and acceptance from my loved one for what I do. I will offer these things in return.
- I have the right to give myself credit for all that I do. It takes courage to be a caregiver.
- Maintain contact with supportive friends and family.
- Rest and sleep as needed.
- Take a break from caregiving when you are able.
- Exercise as able.
- Eat several times daily.
- Find a way to relax (watch a movie, read a book, listen to music).
- Talk to others about your feelings or join a support group
Ready to continue?
If you feel Hospice and / or Palliative care is the right solution for you and your family, then we are here to help you take your first steps! Click below to either learn more about what Agave can specifically do for you, or contact us today so we can start giving you the time you need with the ones you love.
Who is Agave?
Learn about what the Agave family and our team of caring experts can do for you and your loved ones during your time with Hospice.
Get In Touch
Ready to move forward? Have more questions about what Hospice is or what Agave can provide for you and your loved ones? Get in touch today!