Hospice care is given to patients with terminal illnesses who are expected to live for six months or less. Staffed by employees and volunteers, hospices provide medical, psychological and emotional support for patients and their families. Its goals are to ease pain and suffering so that patients may die with dignity and peace. It is available at hospice centers, in your home and in hospitals.

Time Frame

Hospice care is usually recommended for patients who have six months or less to live. However, it's appropriate to discuss the possibility of hospice care with anyone who's been diagnosed with a terminal illness, such as cancer. If patients begin hospice and then improve, hospice can be discontinued and usually picked up again at a later date if necessary. If a patient dies, hospice usually offers emotional and spiritual support to surviving family members for up to a year.

How to Enroll

Many hospices require a referral from a physician before they will enroll a patient. However, you do not need to wait on your doctor to mention hospice to you. Go ahead and begin researching hospices. All hospices are not created equal, so it's important to know which one will be a good fit for you before you ask your doctor for a referral. It's also important to know whether the hospice will accept your insurance coverage. Most hospices accept Medicare, Medicaid and private insurance. However, the policies at each hospice differ slightly. Usually many hospices serve the same area, so there is a good group to choose from. A list of hospices can be obtained from your state's department of health or social services. However, the best way to find a hospice is probably to look in the phone book for a list of hospices.

Questions to Ask

In addition to asking hospices about their insurance coverage, Hospice.net recommends asking the following questions to make sure that you are using the best hospice possible. Are you accredited by a major certifier like Joint Commission or Accreditation of Healthcare Organizations? Are you state licensed? Are you Medicare certified? If the hospice representatives can answer "yes" to each of those questions, that is a good sign. It means the hospice has put forth the effort to meet requirements for patient care and management. Additionally, it's important to ask for a copy of the hospice's policies in writing and to ask for references. A good hospice can provide these on request. Read the policies carefully, especially the sections about payment plans, and then ask any questions you still have.

Additional Considerations

Some additional considerations are listed below. Think about these when you are looking for the right hospice: Good hospices usually evaluate patients and create individualized care plans for them. A good hospice will include the family in this process and will make recommendations for what to do as the patient's condition changes. When you are interviewing hospices, ask about the process that they use to make care plans. Ask if you can see a sample. Some hospices require that your family designate a primary family caregiver. Ask if this is the case and find out what the responsibilities of the primary family caregiver will be. If no one in your family is able to fulfill these responsibilities, ask about other options and/or consider using a different hospice. If you are seeking in-home care and want hospice workers to come to a patient's home, they will first need to visit the home and evaluate the patient and his/her living conditions. Ask how this process works and make sure that the hospice employees will consult with family and existing caregivers as part of this process. If you are seeking in-patient care and want the patient to live at the hospice, arrange a tour of where the patient will be staying. Find out the requirements for admission and find out the maximum length of time that the patient can stay. Ask what happens if a patient no longer qualifies for in-patient care but can't return home. All patients have rights and responsibilities. Ask to see a copy of the patient's rights and responsibilities before you choose a hospice. Most hospices have a 24-hour help line. Find out what to expect if you have questions and need to make a call.

What to Expect

When a patient is enrolled in hospice care, he/she can expect to meet with hospice staff about three times each week. These meetings will involve monitoring health status, administrating medications, changing bandages, providing equipment, and/or talking to the patient about questions, concerns, spirituality or life in general. Sometimes visitors will help with funeral arrangements, power of attorney and living wills. Each visit is adjusted according to the preferences of the patient and the family. Visits with the family may continue for up to a year after the patient's death.

Benefits

It's important to find a qualified hospice that also fits the patient's personality. When this is achieved, both the patient and family can expect the following benefits: increased physical comfort; medical needs are met in a pleasant, non-threatening evironment; fears associated with dying are addressed and, possibly, overcome; the patient dies with dignity and grace; the patient's family has support coping with loss of their loved one; peace of mind.