What is hospice?
Hospice is the continuation of medical care for end-of-life patients. It allows people to live comfortably and with dignity during their remaining days. Hospice care addresses the physical, emotional and spiritual needs and wishes of patients and their families.
Must patients change doctors, if they opt for hospice care?
A patient's physician is an important part of hospice. In fact, when considering this option, patients and their families should start by discussing it with the patient’s doctor. If patients enter hospice, their longtime physician can play an important role in advising and assisting other team members.
Where does this care occur?
Hospice care takes place in a variety of places. Often, patients receive care at home. Care also occurs in hospitals as well as nursing, long-term care and assisted-living facilities. Bon Secours Hospice provides service within a 60-miles radius of Richmond, including the Northern Neck. When needed, short-term inpatient care also is available. This typically occurs when pain control or chronic-symptom management cannot be provided in other settings.
Are respite services available?
Yes. Respite services can give caregivers a much-needed break from attending to a patient at home. In these cases, patients often spend brief periods in a hospital or a nursing facility. We also offer continuous care when a crisis happens and a desire exists to keep a patient at home. Continuous care may last for a minimum of eight hours or a maximum or 24 hours.
When is hospice appropriate? And, who can benefit most from this care?
Hospice is for end-or-life patients who wish to have as much control as possible over their care. It is most appropriate when a patient cannot be cured or opts to end aggressive treatments. No formula exists for pursuing this option because every patient's health and situation are unique. Patients often include – but are not limited to – those with cancer, congestive heart failure, chronic obstructive pulmonary disease, Alzheimer's disease, dementia and other conditions. Certainly, patients want to and should consult with their physicians who can make timely recommendations on hospice as a care option. Plus, hospice may be appropriate, if a patient:
- Has a life-limiting illness
- Requires daily pain medication
- Has recurrent hospitalizations
- Has experienced serious weight loss
- Has difficulty completing daily tasks
- Is no longer seeking curative treatments
- Wants the benefits of hospice care.
Who pays for hospice care?
Funding comes from Medicare, Medicaid, private insurance and individuals. To be sure of coverage, families should check with their employer or health insurance provider.
If a patient has no insurance coverage, can hospice care still be provided?
Yes. No one is ever turned away because of their inability to pay. However, the hospice staff always checks to see if the patient is eligible for coverage that they may be unaware of. If a patient has no coverage, care will be provided and will be paid for using money raised through donations.
Who pays for medications?
Hospice Medicare or Hospice Medicaid Benefit pay for medications tied to hospice care.
Who pays for supplies and medical equipment?
Items that appear in a patient's hospice care plan are covered. The hospice team creates this plan when a patient first enters hospice.
Who pays when hospitalization is needed while a patient is in hospice?
The hospice Medicare/Medicaid Benefit covers a hospital stay for symptom management related to a hospice illness. The patient's physician and the hospice team make the admission decision. At Bon Secours, admission must be authorized by Hospice First – (804) 627-5360.
When should a decision about entering a hospice program be made? Who makes it?
At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice. The law says that the patient must make the decision. Our hospice staff members are always available to discuss concerns or questions with patients, families and physicians.
Who should raise the question about possibly opting for hospice – the doctor, the patient or the patient's family?
Nobody needs to make the decision to enter hospice alone. The Bon Secours Hospice staff has the knowledge, experience and information to help. The first step is to consult the patient's longtime physician. The Bon Secours staff can assist with this conversation, if a patient and his/her family would like.
What if a physician doesn't know about hospice?
Most doctors know about hospice. If your physician wants more information, try the American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local hospices or the National Hospice and Palliative Care Organization Helpline – (800) 658-8898. In addition, anyone can learn more from the American Cancer Society, the American Association of Retired Persons and the Social Security Administration.
If a hospice patient shows sign of recovery, can he/she return to regular medical treatment?
Yes. If a patient improves and the disease appears to be in remission, then the patient can resume aggressive treatment or return to his/her daily life. Typically, Medicare and most private insurers allow added coverage for hospice care, if a patient returns to it after having left due to an improvement in his/her condition.
How does the hospice admission process work?
The process begins with a discussion between patients, families and doctors. Bon Secours Hospice staff can help facilitate this. The formal admission process starts with the hospice staff contacting a patient's physician. This is to ensure that doctor agrees that hospice care is appropriate. Once this is done, the patient signs consent and insurance forms. These are similar to forms required to enter a hospital. The hospice election form says that the patient understands that care is palliative rather than curative. (Palliative means relieving pain and controlling symptoms.) This form also outlines the services provided. Medicare patients also sign a form that explains how choosing Medicare hospice benefits affects other Medicare coverage for a life-limiting illness.
Does home hospice care require special equipment?
The hospice provider assesses each patient's needs and then makes recommendations on equipment and can help obtain it. Often, little equipment is required initially. However, this can change as the disease progresses. Hospice staff members can help answer questions about obtaining and using equipment, and can assist with its acquisition.
How many family members or friends are needed to care for a patient at home?
The number varies with each patient. A hospice team devises a care plan for each patient early on. It addresses many topics, including the amount of care required for a given patient. Plus, hospice staff regularly visits patients to check on them and to answer questions.
Do hospice patients require around-the-clock attention?
Typically, patients do not require constant attention during the early weeks of care. This changes over time. Patients fear dying alone. So, hospice staff recommends someone stay continuously with a patient as he/she becomes weaker. Family and friends can assist with care. Plus, volunteers can run errands and be with the patient while regular caregivers take a break.
How difficult is caring for a hospice patient at home?
Home hospice care is never easy and sometimes can be very demanding. Towards the end of a patient's life, night can be especially challenging. So, hospice staff members are available at all times to consult with family and to make night visits as appropriate.
Does hospice assist family after a patient dies?
Yes. Hospice provides continuing contact and support for family and friends for at least a year after a loved one's death.
Does hospice do anything to hasten death?
No. Hospices neither speed nor slow dying. Hospice supports patients in the final stage of life much as doctors and midwives assist mothers during child birth.
How does hospice manage pain?
Hospice doctors and nurses use the most modern medications and devices for pain and symptom relief. Other experts also assist in making patients more comfortable. Physical and occupational therapists help patients be as mobile and self-sufficient as possible. Other experts may aid with diet counseling and using music, art and other therapies. Additional counselors can assist patients and their families deal with emotional and spiritual pain.
Will medications prevent a patient from being able to talk or knowing what's happening?
Hospice strives to help patients be as comfortable and alert as possible.
What are bereavement groups?
Bon Secours Hospice helps individuals who have lost a loved one deal with their grief through bereavement groups. These offer support and allow people to learn more about the grief process and how to celebrate and to honor those who have died. Groups meet weekly during the day and evening.
Who would benefit from attending a bereavement group?
Anyone who has lost a loved one and would like to attend is welcome.
What happens during a bereavement group meeting?
A highly-trained grief professional assists the group in recognizing and understanding "symptoms of grief" – the normal thoughts and feelings of grieving. Trained volunteers also help provide added support for each group member.
Do I have to talk at a bereavement meeting?
No. Group members never are pressured to talk before they are ready to share. Just come, listen and realize you are not alone.
How long does a bereavement group last?
Generally, bereavement support groups run continually throughout the year. We do ask that you commit to attend eight to 12 sessions. This is typical for most grief programs. Group sessions usually last 90 minutes.
Are bereavement groups open only to friends and families of hospice patients?
No. Anybody who has lost a loved one may attend the support groups.
How do people register for bereavement groups?
A face-to-face pre-registration meeting is required. To learn more or to schedule an appointment, please contact the Bon Secours Hospice Bereavement Coordinator. Either call (804) 627-5360 or email HospiceBereavement@bshsi.org.
Are bereavement groups free?
Yes. All bereavement support groups are free.
How do people donate to support hospice?
Donations can be made at any time. Please send gifts to:
Bon Secours Hospice
8580 Magellan Parkway
Richmond, Virginia 23227
What are some good online resources about hospice and related issues?
Some of the best include:
- National Hospice and Palliative Care Association
- Virginia Association for Hospices and Palliative Care
- Caring Connections
- Advanced Directives
- Hospice Patients Alliance