MultiCare Health System

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Hospice FAQ

What is Hospice?
Hospice is a philosophy of care designed to help patients, family and friends come to terms with end-of-life issues. Our program emphasizes living life as fully and comfortably as possible. The focus of care is on comfort rather than cure, and embraces not only the patient but family and caregivers as well. The goal is to facilitate a peaceful death and bereavement. Comfort care, from the hospice perspective, includes not only aggressive medical management of physical symptoms but emotional and spiritual needs as well.

What is Palliative Care?
NHPCO's Standards of Practice for Hospice Programs describes palliative care as treatment that enhances comfort, and improves the quality of the patient's life. No specific therapy is excluded from consideration. The test of palliative care lies in the agreement between the individual, physician(s), primary caregiver, and the hospice team that the expected outcome is relief from distressing symptoms, the easing of pain, and/or enhancing the quality of life. The decision to intervene with active palliative care is based on an ability to meet stated goals rather than affect the underlying disease. An individual's needs must continue to be assessed and all treatment options explored and evaluated in the context of the individual's values and symptoms. The individual's choices and decisions regarding care are paramount and must be followed.

Who makes the decision about entering hospice and when should it be made?
By law, the decision belongs to the patient. Any time during a life-limiting illness can be appropriate to discuss all of a patient’s care options, including hospice, with the patient’s physician.

What if a hospice patient shows signs of recovery?
If the patient’s condition improves and the patient’s physician agrees that the disease seems to be in remission, they can return to aggressive therapy or continue on with their daily life.

What does the hospice admission process involve?
The process begins with physician certification stating life expectancy of six months or less and the patient has made a decision to seek comfort care only. If the diagnosis is not cancer, it must meet Medicare/Medicaid criteria (most private insurance agencies use similar criteria). Finally, there must be a caregiver in place or there must be a plan to acquire one when necessary.

Does hospice do anything to make death come sooner?
No. A hospice program can do nothing either to speed up or to slow down the dying process.

Is caring for the patients at home the only place hospice care can be delivered?
No. We support patients at home, in nursing homes, adult family homes, hospice centers and hospitals.

Is hospice care covered by insurance?
Hospice coverage is provided by Medicare, Medicaid and by most private health insurance policies. Medicare and/or Medicaid are the most frequent sources of payment. Both will pay for medication relating to the terminal diagnosis, equipment needed for comfort and safety (typically a hospital bed, bedside commode and wheelchair) and the services of the hospice team. To be sure of coverage, families should, of course, check with the health insurance provider.

Who refers to hospice?
Referral sources include physicians, hospitals, nursing homes, assisted living facilities, friends, neighbors and patients. While a physician’s order is required to admit to hospice, no order is needed to obtain information about the service. Anyone can refer a potential patient.

Do you provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. We also sponsor grief and bereavement groups.