What is hospice care?
Also known as end-of-life care, hospice care provides comfort and support to help maintain the quality of life for those of advanced age or with terminal illnesses. This care focuses on pain relief and comfort for both the patient and their family. Instead of attempting to treat the underlying illness, staff at hospice care facilities treat the patient and their symptoms, letting the individual spend their last days as comfortably as possible.
Hospice care services
Hospice care provides holistic support for a patient’s physical, spiritual and emotional needs, as well as emotional support for their family.
Both in-home and inpatient hospice services offer symptom management, emotional support, counseling services and spiritual care with a religious leader of your choice. Hospice care also includes support for caregivers and family members, including respite care, family meetings and bereavement support.
Some basic services hospice caregivers provide include:
- Bathing and dressing assistance
- Food preparation
- Laundry and chores
- General companionship
- Doctors’ appointments
These services include any necessary medical equipment, supplies or medications. The company may include short-term inpatient or respite care if the patient is still at home. The goal is to keep the patient comfortable and alert, and hospice involves the services of doctors, nurses, counselors, religious advisors and social workers.
Palliative care is a specific kind of hospice care that helps people with terminal illnesses live out their last days comfortably. Unlike hospice care, palliative care can start the moment the patient is diagnosed. Palliative treatment includes pain management, specialized medication, physical therapy and other tasks and services.
How much does hospice care cost?
Hospice care ranges from $150 to $750 per day. Home care is a lower-cost option, while end-of-life care in hospitals and care facilities is more expensive — this can amount to around $10,000 per month for the average patient. Medicare, Medicaid and most private health insurance plans will cover a portion of or all these costs, however. There could be copayments for prescriptions or services unrelated to the illness.
Will Medicare cover hospice care?
Yes, Medicare covers hospice care and offers a no-cost option for those who qualify. A hospice provider must be Medicare-approved to be covered. There might be a copayment for prescriptions or other services, but private insurance plans or Medicare supplements can help close any gaps in coverage.
Do medicare supplemental insurance plans cover hospice care?
Yes, Medicare Supplemental Insurance, or Medigap, will cover the cost of hospice services and other health costs unrelated to a terminal illness. Medigap typically kicks in to cover copayments, coinsurance, prescriptions, respite care and other expenses not covered by Medicare. With this combination of coverages, 100% of your hospice care costs could be covered with no out-of-pocket expenses.
Can you get hospice care without insurance?
Yes, you can get hospice care without insurance. You can pay out of pocket, and some facilities offer services on a sliding fee scale if you’re unable to afford hospice care. Hospices should have someone on staff who can discuss costs and payment options with you or help you qualify for charitable care with the provider.
Does insurance cover hospice care at home?
Most private insurance plans provide coverage for hospice care, including visits or full-time nursing care at home. Contact your insurance provider to learn which services are covered and if there are any out-of-pocket costs like deductibles or copayments for prescriptions, skilled nursing or other services.
Hospice care FAQ
- Can I have hospice care in my own home?
- Yes, hospice care can take place in your home or in an assisted living facility or nursing home. In-home hospice care is significantly more affordable than inpatient care and involves the cooperation of nurses, doctors and the patient’s family and friends to provide around-the-clock care.
- How do I find a hospice program?
- Ask your doctor for a recommendation for highly rated hospice care providers or facilities in your area. You can also research providers within your insurance network or who are Medicare-approved and read reviews from patients and their families. Once you’ve selected a hospice provider, you can request a tour to see the facility and meet the doctors.
- Is palliative care different from hospice care?
- Hospice care is exclusively for those who are terminally ill and are no longer receiving curative treatment. Palliative care, however, is used to treat symptoms of anyone with a serious illness, even if it isn’t life-threatening. These patients typically still receive treatment for their illness or disease. For example, someone still receiving chemotherapy treatment for cancer would receive palliative care but then might transition to hospice if the treatment is ineffective or if the patient wishes to end treatment.
- Can you go to hospice if you aren't dying?
- No, hospice is only for those who have terminal illnesses and a prognosis of no longer than six months. For those who need care but are expected to recover, palliative care services offer support and comfort at any stage of a serious illness. For example, a patient battling cancer may receive palliative care while getting chemotherapy or radiation treatment.
- Can you go on and off hospice care?
- Yes, you can end your hospice care at any time. Patients typically do this when they want to try treatment again or if their condition improves while in hospice. The patient may also choose to leave hospice if they are dissatisfied with the service they’re receiving or if they wish to return home (though in-home hospice care is also an option). Afterward, the patient can begin hospice care again as long as they still qualify through insurance or Medicare.
- Does hospice care include bathing?
- Yes, hospice care covers daily care activities like bathing and dressing. These services are usually performed by a hospice aide who can assist with eating, using the bathroom and other care needs. Keep in mind that in-home hospice care is typically not full time, so family or friends might need to provide additional support when the caregiver isn’t present.
- How are hospice care services provided after hours?
- Hospice care is available 24/7, so you can arrange after-hours or overnight care with your hospice provider. The provider will send a hospice nurse to care for the patient and help with any needs that may arise, such as assistance using the bathroom, bathing or eating. If inpatient care is part of the patient’s treatment, overnight nurses will check in on them and ensure they are supported throughout the evening and night.
- How long can hospice care last?
- The timeline of hospice care depends on the patient’s illness and personal timeline. Patients may be in hospice care for six months or as little as a few days if an illness or injury progresses rapidly. Since it’s difficult to accurately predict how long someone might live, if patients live longer than the predicted six months, they can remain in hospice care as long as they meet the requirements for Medicare or private insurance.
- When you are in hospice, can you still go to the doctor?
- Your hospice care team includes doctors, nurses and hospice aides, but you may continue to see your primary care physician as needed. Medicare and Medicaid patients are required to get permission from the hospice provider before seeing another doctor.
When is it time for hospice care?
Hospice care is for those at the final stages of advanced age or an incurable, terminal illness. These services are particularly valuable for those having difficulty caring for themselves or those with uncontrolled pain, nausea, mental impairment or other side effects due to a serious illness.
Families can also benefit from hospice care, as it provides helpful support and stress relief. Some hospice providers offer respite care to give caregivers temporary breaks overnight or for a short term.
The decision to move to hospice is a difficult one to make, but there are a few indicators that can help you determine when you or a loved one is ready. If they’ve had to deal with frequent hospitalizations or infections, rapidly declining health, uncontrollable pain, shortness of breath, nausea or vomiting, hospice care can provide relief and comfort.
Similarly, if you’ve noticed increased difficulty as your loved one performs daily tasks or a reduction in their appetite, alertness, lucidity or energy levels, it might be time to discuss the need for hospice care with your doctor.
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