When should a decision about entering a hospice program be made – and who should make it?
At any time during a life limiting-illness, it is appropriate to discuss the patient’s care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping curative treatment and allowing the disease to take its natural course. Hospice staff members are highly sensitive to these concerns and always are available to discuss them with the patient and family.
Does Care Partners provide service in my area?
Care Partners serves families throughout the Portland area and Washington County. To confirm we provide service in your area, please visit our Service Area page.
Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
How do I qualify for hospice care?
Hospice is for patients with an advanced or serious illness. These illnesses may include cancer, heart or lung disease, progressive neurological disease, liver or kidney disease as well as any condition with a limited life expectancy if the disease runs its normal course. In addition, patients receiving hospice must choose to receive care that focuses on palliation or comfort rather than life prolongation. To receive hospice your physician must find that it is likely that you will die in the next 6 months.
Can I change my mind and leave the hospice program?
Absolutely. If a patient’s condition improves or stabilizes or the disease seems to be in remission, patients can be discharged from hospice and may even return to aggressive therapy. If a discharged patient should later need hospice care, Medicare and most private insurance companies will allow coverage to resume.
What does the hospice admission involve?
If the patient’s physician did not make the referral to the hospice program, Hospice will contact the patient’s physician for approval. A hospice team will then visit the patient at his/her place of residence to assess and gather information. The patient or representative will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The signed election form says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. This form also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.
Is there any special equipment or changes I have to make in my home before hospice care begins?
Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible. Equipment is usually covered by insurance.
How many family members or friends does it take to care for a patient at home?
There is no set number. One of the first things a hospice team will do is design an individualized care plan that will, among other things, address the amount of care giving needed in an individual situation. Hospice staff visit regularly and are always accessible to answer medical questions and provide support.
Must someone be with the patient at all times?
In the early weeks of care, it is usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. There are a variety of ways that respite care can be provided to the caregiver if requested.
How difficult is caring for a dying loved one at home?
The process of dying is different for every person – how long it takes, how disabling it is. Caregiving can become challenging. Nights can be long and sleep disrupted. Hospice staff teach caregivers the “how-tos,” are available to answer questions 24-hours a day, and help you to know when to seek additional help if necessary.
What specific assistance does hospice provide home-based patients?
Hospice patients are cared for by a team of highly trained physicians, nurses, social workers, counselors, home health aides, therapists, and volunteers – each providing assistance based on his or her area of expertise. In addition, hospice helps provide medications, supplies, equipment, hospital services, and additional helpers in the home, if needed.
Does hospice do anything to hasten death?
Hospice does nothing either to speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge during the dying process. For patients who want information about Oregon’s Death with Dignity option, we will make a referral to appropriate resources.
Is caring for a patient at home the only place hospice care can be delivered?
No. Hospice patients may also live in nursing homes and adult care homes. Inpatient hospices are available for those whose medical needs cannot be met in the home setting.
How does hospice manage pain?
Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain. Nurses and physicians are continually trained in state-of-the-art pain and symptom relief, with the goal of keeping patients fully alert while being pain free. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling.
What is hospice’s success rate in battling pain?
Very high. Using a combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.
Will medications prevent the patient from being able to talk or know what is happening?
Usually not. It is the goal of hospice to allow the patient to be pain free but alert. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
Is hospice care covered by insurance?
Hospice coverage is widely available through Medicare and HMOs. Benefits for hospice care are provided by Medicare, Medicaid and most private health insurance policies.
Is hospice affiliated with any religious organizations?
Care Partners is not affiliated with any religious organization. While some religious organizations have hospice programs (sometimes in connection with a hospital), our hospice serves the entire community and does not require our patients to adhere to any particular beliefs or receive chaplain visitations. However, all religious traditions are respected by hospice professionals, as are persons who have no chosen tradition.
If the patient is eligible for Medicare, will there be any other costs?
Medicare covers all services and supplies that are related to the terminal illness.
What is covered under the hospice benefit offered by private insurance companies?
While hospice benefits can vary significantly between insurance companies and individual health plans most insurers offer coverage similar to Medicare. Hospice will gladly check your insurance coverage and explain the benefits under your plan.
What services are covered under the Medicare Hospice benefit?
Medicare pays hospice a daily fee to provide the following services related to the patient’s terminal illness:
- physicians’ services
- nursing care (regular visits)
- medical appliances and supplies
- outpatient drugs for symptom management and pain relief
- short-term acute inpatient care, including respite care
- hospice aide (bathing assistance) and homemaker services
- physical therapy, occupational therapy and speech/language pathology services
- medical social services
- counseling, including dietary and spiritual counseling
If the patient is not covered by Medicare or another health care plan, will hospice still provide care?
The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, most hospices will provide service for anyone who cannot pay using philanthropic dollars and memorial gifts.
Does the hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least 13 months following the death of a loved one. Care Partners also provides bereavement groups and counseling programs for anyone in the community who experienced a loss, including children and teens.
Who will provide care for me when I am on hospice?
You will receive care from the Hospice team composed of:
- Your Primary Care Physician
- The Hospice Medical Director
- Registered Nurses, skilled in pain management and symptom control, provide routine, scheduled home visits
- Medical Social Service Counselors facilitate access to resources, offer emotional support and assistance in financial matters
- Grief Counselors provide counseling for anticipatory and post death support for the patient and family. Bereavement services are provided for 13 months post death to family and loved ones
- Chaplains provide emotional and spiritual support
- Hospice Aides provide personal care, such as bathing, shampooing, back massage, bed changing and other services
- Trained Volunteers who provide respite, companionship and emotional support
- Complimentary Therapies that may help relieve symptoms, such as massage and music therapy
Does Care Partners have a non-discrimination policy?
Care Partners complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Care Partners does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, contact the State of Oregon Civil Rights Division.
If you believe that Care Partners has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
State of Oregon Civil Rights Division
800 NE Oregon Street, Suite #1045
Portland, OR 97232
(971) 673-0764, TTY: 711
Fax: (971) 673-1384
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the State of Oregon Civil Rights Division (CRD) is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html