Six Important Facts You Must Know
About Hospice Care
Welcome to iServe Hospice
At iServe Hospice, we understand that a lot of families or patients are grappling with questions once their loved ones have been diagnosed with terminal illness or Hospice has been suggested by the physician.
Based on experience and encounters with families and patients in Hospice, we will answer as many questions as possible on this page. Please send us a message or call at 469-379-2682 if you have additional questions and want to admit your loved one to iServe hospice care.
Do You Have More Questions? Send Us a Message
What is Hospice Care At Home?
- Hospice care at home is the act of providing comfortable and compassionate care by the hospice team to a patient in the last phases of terminal disease at the comfort of their home or place of residence.
- Hospice care at home focuses on ensuring that patients whose life-limiting illness has been advanced are receiving the necessary quality of care to keep them pain-free and comfortable at their home or place of residence.
- iServe Hospice team is not here to treat your disease but to ensure that you receive a quality end-of-life experience. Putting patients and families first has been our number priority.
What Services Are Provided in Hospice?
With iServe Hospice Care, You will receive the following care:
- The Entire Hospice Team
- Support for You and Your Loved ones, 24/7
- All Services are Covered by 100% Medicare & Medicaid
- We Manage all Medication Needs
- Required Medical Equipment and Supplies are Covered 100%
- Hospice Medical Director Available to Answer Your Questions or Face to Face Visit as Needed
- Continuous Care, Respite, and or General Inpatient as Needed
- Weekly Visits by The RN
- Hospice Aide Visits Depending on Needs
- Social Worker Visits Upon Request
- Chaplain Visits Upon Request
- Volunteer Services Upon Request
- On-Call Visits by The RN or Other Team member as Needed
- Assistance With Funeral Arrangements
- Bereavement Services
When is Hospice Care Recommended?
- In hospice care at home, the top diagnoses that would require immediate evaluation and possible admission to hospice are Cancer, Non-Alzheimer’s Dementia, and most neurological diseases such as Parkinson’s disease, Multiple Sclerosis, ALS, and Huntington’s disease.
- Admission to hospice occurs when there is a decline in condition with the above diagnosis and consultation with your primary care provider or Hospice Medical Director.
- If the disease runs its usual cause, other life-limiting conditions with six months or less prognosis would require hospice. Such diseases include Aids, Cerebral Vascular Accidents (CVA), Congestive Heart Failure, Cardiopulmonary Disease (COPD), Liver and Renal Disease.
- Other factors that may accompany these diagnoses include; the number of hospitalizations in the last six months, clinical labs, constant weight loss, the severity of pain, persistent generalized weakness, fatigue, and other visible symptoms such as continuous nausea and vomiting.
- In general, the recommendation for hospice occurs when doctors believe that comfort care is the only option. In other words, the patient and family decide not to pursue aggressive treatment, hospitalization, and tube feeding due to a lack of progress from curative treatment. Both the patient/family and the doctor would agree that comfort care is the best option at this time.
How long is Hospice Care?
- The answer to this question may have a different response based on whether you want to know how long would the patient live or how long does Medicare allow for Hospice.
- First, let’s discuss how long a loved one would live. As a registered nurse, this is one of the most common questions I get from family members. Some believe that Hospice stands for death. Although some patients whose condition has deteriorated could pass away within minutes, a day, or two after admission to Hospice, the opposite is the case in most hospice admissions.
- Depending on the patient’s condition, some may live up to six months to a year or even more before passing away. Although some patients may begin to show symptoms such as unresponsiveness and other breathing signs such as apnea, prediction of death is still not appropriate at this time.
- As stated above, a patient may be in Hospice for up to a year; this will help answer the question; how long is Medicare coverage for Hospice? The usual period Medicare allows for Hospice is six months, and a benefit certification period every 90 days.
- After evaluation by the RN and Face to Face visit by the physician, if the patient continues to qualify for Hospice after six months, benefit certification for Hospice would continue every 60 days.
Who pays for Hospice Care?
- Who pays for Hospice Care?: Hospice covers Medicare based on specific criteria. The coverage of hospice by Medicare was established in 1983 by the US government to prevent financial burden to patients who may have a terminal diagnosis. The purpose was to enable these patients to have quality end-of-life care.
- To qualify for Medicare coverage of hospice, the patient must have a diagnosis certified by an appropriate physician to be six months or less and accept hospice if curative care is no longer effective. Another question families may have is:
- What hospice services do Medicare Cover?: As long as a patient qualifies for Medicare and lives at home, Medicare will cover 100% all services the patient needs throughout their stay in hospice.
- Medicare covers any service that a patient needs to maintain comfort during the end of life, including:
- Hospice Team: The Medical Director, RN, Social Worker, Chaplain, Dietician, Hospice Aide, and Volunteer.
- Medical Equipment: The most common hospice equipment requested by family members are hospital beds, overhead table, oxygen concentrator, bedside commode, shower chair, walker, cane, and wheelchair. Others may include a suction machine, bedpan, air loss mattress, Hoyer lift, bed alarm, etc.
- Medical Supply: Most families would immediately request incontinent supplies and wound care supplies.
- Medications: Comfort care medications prescribed by the hospice medical director may include morphine for pain, lorazepam for anxiety, Zofran for nausea, Senna Plus or Basicodyl for constipation, acetaminophen for fever, and atropine for excessive secretion. These medications may vary depending on the hospice medical director or physician.
- Bereavement: Funeral arrangements for the family and bereavement assistance for up to a year after the patient dies are part of the patient’s hospice care.
- General Inpatient (GIP): One of the criteria for Inpatient Care qualification is if a patient cannot swallow pills by mouth. Not taking food or drink by mouth allows the hospice team to provide intravenous medication to the patients and can only happen at an inpatient facility. Other criteria would be when a patient is too sick and requires constant medication changes by an RN to maintain comfort.
- Continuous Care: Medicare would also cover continuous care for patients who are too sick. Criteria include visible symptoms requiring constant medication administration, such as intractable pain, nausea, vomiting, agitation, anxiety, etc.
- Respite Care: Medicare would cover Respice Care when a family is burned out and needs to take a break from the patient or have other reasons to be away. With the hospice’s assistance, the family may take the patient to an assisted living facility, group home, nursing home, or other accepted facilities for five days.
- Medicare may cover other hospice services that are not always a need but must be available. These services are physical therapy, occupational therapy, speech therapy, and dietitian.
What Hospice Services Do Medicare Not Cover?
Coverage of hospice by Medicare solely depends on the guidelines that Medicare gives. Medicare will not cover services that are not a part of hospice diagnosis.
- Treatment of Terminal Diagnosis: Medicare would not pay for any therapy intended to cure terminal diagnosis. For example, if a patient comes to hospice due to cancer diagnosis, Medicare would only pay for medications relating to cancer diagnosis. If the patient is already taking medication for blood pressure, for example, since blood pressure is not associated with the primary hospice diagnosis, Medicare would not cover the blood pressure medication.
- Provision of Care by The Wrong Hospice Organization: Patient and family must approve all care by an agency by signing appropriate consent. Medicare will not pay for any services that do not contain consent by the patient or family and proper certification for the hospice medicare director’s terminal of illness.
- Room and board: The charges for living in a nursing home or long-term care facilities are room and board. Medicare does not cover the fees that patients pay for living at these facilities.
- Additional Care: Medicare will not cover the extra care that a hospice agency provides to a patient. These care are part of hospice obligation, and they include skilled nursing, wound care, therapy, and dietitian.
- Respite Care: Patient/family may pay 5% of the Medicare-approved amount for Respite Care.