When a loved one is diagnosed with a terminal illness, you know that each moment left with them is precious. You want them to be comfortable, stable, and as happy as they can be. This is a time when quality of life becomes absolutely essential, and often a hospital setting is unable to offer the right level of care and comfort for your loved one.
Hospice care is an alternative to the traditional hospital setting for those with a terminal illness, providing support and comfort for those afflicted by such malady. The goal of hospice care is to increase the quality of the remaining time the patient has left. It can be given in a hospital setting, nursing home setting, or even at the patient’s residence or that of a family member.
Hospice care is often confused with another type of care, called palliative care. These two are similar in many aspects and are often confused. Palliative care offers and extra layer of medical, emotional, and social support to the patient and their family. It is often offered in conjunction with a curative treatment, and is simply a way to make the patient’s quality of life better while battling the illness or disorder.
What is the Difference Between Hospice and Palliative Care?
Hospice and Palliative care share some similarities in their support networks and flexibility, but are notably different in many ways. For instance, hospice care is focused on those with a terminal illness rather than a chronic one that is being treated. One of the biggest misconceptions about hospice care is that it’s only available to cancer patients, which is a myth; hospice care is available to patients with a terminal illness with a physician’s referral.
Palliative care offers extra medical and emotional support to those with chronic disorders that make daily life uncomfortable or unmanageable. This type of care focuses on providing extra comfort while a curative treatment is underway for the illness or disorder. Hospice care, on the other hand, does not work in conjunction with a cure or treatment, but rather makes the patient’s final days more comfortable.
There are additional resources to assist patients in paying for hospice care should their private insurance not cover the costs, whereas palliative care patients need to meet certain criteria for their insurance company to cover the cost. Hospice care is usually given where the patient lives. Sometimes, a patient or their family will move them home for the final months of life, and hospice care is carried out in their personal home.
Types of Hospice Care
During the course of hospice care, a patient may require different levels of medical or emotional support, depending on the progression of the illness and the patient’s reaction to it. It is not uncommon for a patient to go back and forth between regular home care to inpatient hospice care throughout the progression of their medical condition. There are several types of hospice services that offer different levels of care to the patient and their family.
Hospice Care at Home
If a patient or their family so choose, hospice care can be offered in their personal home or apartment, or even a nursing home. This type of care usually requires a visiting nurse, doctor, social worker, and/or bereavement specialist, who will assist the patient’s family or nursing home staff in daily routines such as bathing, toileting, eating, and changing clothes, and aid the patient emotionally in accepting the illness and the inevitability that comes with it.
The nurse or provider also administers medications or other medical treatments for acute symptoms of the terminal illness, such as pain or discomfort.
Home hospice care can be offered as routine or continuous care. Routine care is exactly as it sounds, care that is given at routine times throughout the day, whereas continuous care involves provider taking shifts to provide a 24-hour care network to the patient.
Respite Care
Respite care is a short-term care option when the patient’s family cannot provide the level of care the patient requires at home. Scheduling conflicts with work, school, and family, or simply the inability to provide the necessary arrangements for the patient can cause a family to seek respite care. Respite care usually has a limit to the number of days it can be used, giving the patient’s family a break from the rigors of daily care.
Inpatient Hospice Care
When the patient’s symptoms become unmanageable at home, they can be admitted to an inpatient hospice unit, which is also temporary and only offered until the symptoms can be managed and the patient is able to return to whichever home setting they inhabit.
This can be a great option for family members when the care of a passing relative becomes too emotionally or physically taxing. Having to be by a loved one’s side as they pass on can be incredibly difficult for some to fully understand and process, and so a step away is often beneficial to maintaining the stability of the family members.
Additional Services With Hospice Care
Bereavement Services
The death of a loved one, especially when it’s from a progressing disease or illness can be particularly impactful to those loved ones they leave behind. Many hospice care programs offer bereavement services to those loved ones after the patient passes, some up to a year afterward. It is important to remember that a support network is also important for those close to the patient, as the death of a loved one is never easy.
Medical Social Services (Case Worker)
Social workers can offer a variety of services to the patient and their family, including counseling and other community resources to assist in easing the difficulty of terminal illness. The medical social worker can also act as a case manager when the illness is complex. They will work with doctors, care providers, and the family to coordinate and direct appropriate care and other services. A social or case worker can also provide a sort of “friendly face” for the patient to become familiar with during their time in hospice.
Spiritual Services
Depending on the patient’s religious views, a priest, rabbi, imam, or other equivalent is often included in the hospice care plan. The religious figure can help ease the emotional discomfort of a terminal illness, offering spiritual advice and consolation to the patient and their family. Often the church or clergy will offer spiritual services for hospice patients free of charge. The fee (if any) will vary based on the church, but usually if there is a fee, it’s only a small donation to the church by the family after the loved one has passed.
Physical or Speech Therapy
Certain terminal illnesses progressively degrade a patient’s ability to speak or move, making daily routines difficult and even having a negative effect on the overall morale of the patient. Some hospice care programs can provide services to help combat loss of movement and speech. Retaining the ability to speak and/or move can do wonders not only for the patient, but the family as well, keeping their spirits high while giving the patient some of their independence.
Who Pays For Hospice Care Costs?
Hospice care is covered by Medicare and Medicaid, and also by many private insurances. Some hospice care centers or services offer free or reduced payments via charitable donations and gifts from the community at large. These services are available to those who qualify and are generally funded by the public or by private institutions. They cover everything from prescriptions to physician and nursing costs, to speech and physical therapy. Be sure to research these programs in your area if you feel that covering the costs of hospice care will not be possible by you or your family members.
Medicare
Medicare does cover the cost of hospice care. For benefits to take effect, you must meet the following criteria according to the medicare.gov document:
- Your hospice doctor and your regular physician certify that you are terminally ill. Normally this means you have about six months or less before the terminal illness reaches its termination.
- You accept palliative care instead of a curative care of treatment for your illness. Focusing on comfort and quality of life rather than on curing your illness.
- You must sign an agreement stating that you wish to receive hospice care instead of other services such as treatment or curative services.
Medicare offers a wide variety of providers and hospice services that are in network. You have the right to choose which option is best for you and what hospice care program will offer what you’re looking for. You’ll want to research whether or not extra services are included, such as spiritual services, medical social services, and speech or physical therapy.
According to the Medicare site, your Medicare benefits should cover:
- Physician services, nursing services, and hospice aides
- Medical equipment related to your hospice care, such as wheelchairs and beds, or other medical equipment.
- Any prescription drugs that you’ll be taking
- Physical, occupational, or speech therapy
- Social workers and counseling services
- Bereavement support and counseling for your family members
- Short-term inpatient or respite care
Always be sure to fully research your options and be certain they cover your chosen plan, and provide all the resources you’ll require. Be sure to include your family with bereavement services such as group counseling, to also help them through this difficult time.
Medicare does not cover curative treatments for your illness, any and all care that was not outlined in your hospice care plan, and any prescription drugs that aren’t focused on comfort (such as pain medication). It also does not cover your room and board, except when you’re admitted to an inpatient facility. There is no deductible for your hospice care, Medicare will pay the provider(s) directly. You’ll still pay your monthly premiums, and a small cost for prescriptions. (Up to $5 per prescription). Medicare will also cover the cost of any medical related transportation, but does not cover without a co-pay events such as an emergency room visit during hospice. This would still fall under a regular hospital visit, and be subjected to routine charges as outlined in your medicare plan.
Medicaid
To qualify for hospice care benefits with Medicaid, the requirements are very similar to Medicare programs. You must:
- Be certified as “terminally ill” by your physician; usually indicating a six month or less expected lifespan
- Be willing to forsake any curative treatments and instead focus on making your remaining time confortable. Hospice care does not provide any curative treatment for illnesses, and your insurance may not cover them at all if you’re part of a hospice plan.
- You must sign an agreement that states you wish to accept hospice care instead of regular care or curative treatments.
Medicaid also offers the same coverage as medicare, providing everything you need to make your hospice choice easy and the experience as comfortable as possible. Services covered are as follows:
- Physician services, nursing services, and hospice aides
- Medical equipment related to your hospice care, such as wheelchairs and beds, or other medical equipment.
- Any prescription drugs that you’ll be taking
- Physical, occupational, or speech therapy
- Social workers and counseling services
- Bereavement support and counseling for your family members
Be sure to check with your Medicaid provider and ensure that each service you need is covered in your plan. Medicaid is free of charge to those who qualify, and so your hospice services will also be free of any copays or payments.
Private Insurance
Private insurance varies by company, plan, and patient. Different plans have different types of coverage. Hospice care may not be an available option although most large insurance companies do offer it. What is covered by your plan will vary greatly if it an option. Before you choose a hospice plan, be sure to check with your insurance company for a few things:
- Does the plan you’ve chosen, and all its services, fall under your company’s coverage?
- What co-pays, if any, are you responsible for?
- Are there any out of pocket costs that you’ll incur if you need services outside the coverage options?
Most private insurance companies will cover your basic medical costs and prescriptions, but charge you a copay to do so. You’ll want to figure out the amounts you’ll be paying beforehand, as a terminal illness will probably leave you unable to work and the responsibility for co-pays will fall to your family members. Having an open discussion about hospice care options with your loved ones is a great way to keep them involved and informed about what expenses come with this option.
Check if hospice care is covered in your healthcare plan outline. It’s a good idea to call your provider and discuss how the billing works, what you’ll be charged for, and what extra things to expect throughout the process, so there are no big surprises at the end for your family members.
How To Find Placement for Hospice In Scottsdale, AZ
If you or a loved one require hospice care in the Scottsdale, AZ area, there are many options for you to consider. Here at Above and Beyond Senior Placement Service, we help you understand what those options are. Our free guidance can help you create a plan that helps you take care of the ins and outs of hospice placement. We provide you with information for local hospice services and let you decide the rest. If you have any questions about hospice care, we help answer them for you.
A Few Things to Remember
Searching for hospice care can be a stressful project, especially considering the circumstances that require such care. Most insurance plans cover hospice care in the policy. Whether you have Medicaid, Medicare, or private insurance, though some private companies require co-pays, your Medicare plan will only charge you a small fee for prescriptions and your monthly Medicare premiums. Remember that in order to cover hospice services, insurance companies often have certain criteria to meet in order to qualify.
Hospice care is not the same as palliative care; you will not be working to treat yours or your loved one’s illness. Hospice care is focused on ensuring the quality of life. For the remaining time the patient has left, they provide medical, spiritual, social, and emotional support. You can choose the details of your plan, and whether or not to include things like speech or physical therapy, spiritual or mental health/grief counseling, and more. You have the right to make these choices as well as the facility (should you choose to stay at a facility, and the facility falls within your insurance network).
If you choose to have your hospice care at home, be sure to choose the right schedule, routine, or continuous care that fits your medical and emotional needs.
This can be a trying time for family members, so always include bereavement or grief support options to them, and make sure they are aware that inpatient hospice care is available for a limited amount of time should they need a break.
You can ask your provider or your insurance company to suggest reputable hospice care facilities or services. Your insurance provider will have “in-network” facilities that they will pay directly. As with any out of network medical expense, your insurance may not cover many of the expenses, if any at all. Talk to your provider and review your insurance policy to ensure proper coverage.