There are many misunderstandings and misconceptions regarding hospice care. You have heard about hospice care and that it has something to do with end of life. But do you really know what it is? The US Code of Federal Regulations defines hospice care as a comprehensive set of services coordinated by a care team to provide for the physical, psychological, spiritual, and emotional needs of a terminally ill patient and the patient’s family members. Simply put, it is comfort care for the patient and their loved ones.
For most seniors, the cost of hospice care is provided by Medicare. In order for you to qualify for the Medicare hospice benefit, you have to be terminally ill. This means that you have a medical diagnosis that you will be expected to live six months or less if your illness or other medical condition runs its normal course. Even when you are receiving Medicare funded hospice services, you may still continue to utilize all of your other Medicare provided services that are unrelated to the hospice diagnosis.
In today’s column, we will discuss some of the most common misconceptions about hospice care. These misconceptions were originally summarized by Grace Hospice and I thought that they would make a good topic for one of my columns.
Misconception#1: Hospice is a place.
Truth: Although hospice services can be provided in a hospice home, they also can be offered wherever the hospice patient calls “home.” This can be in a private home, an assisted living facility, or a nursing facility. In addition, Medicare will also pay for short-term 24 hour a day inpatient care in a hospice home, hospital or nursing facility for pain control and symptom management, or for respite to provide relief for the patient’s caregiver(s).
Misconception#2: Hospice is only for cancer patients.
Truth: Hospice care is not limited to any one disease or illness. Any terminal illness or medical condition in which the medical diagnosis is a six month or less life expectancy is appropriate for hospice care. This includes, but is not limited to, liver disease, renal disease, Alzheimer’s disease, respiratory diseases and cardiac diseases.
Misconception #3: Hospice is giving up.
Truth: Hospice affirms life and provides relief from pain and distressing symptoms. Hospice care neither prolongs life nor hastens death. Hospice is about living life to the fullest when no cure is possible. Hospice offers the most effective management of the disease process. The goal of hospice care is to improve the quality of a patient’s last days by offering comfort and dignity.
Misconception #4: Hospice is expensive.
Truth: Medicare and Medicaid generally pay 100% of qualifying hospice care services. If you are not on Medicare or Medicaid, check your health insurance policy provisions. Commercial insurance companies generally reimburse hospice care expenses in the range of 60-100%, depending on your plan.
Misconception #5: Hospice patients have all existing medications and treatments taken away.
Truth: Current medications and treatments are reviewed for appropriateness by the hospice care team, as well as by the patient and family. Hospice pays for all medications and supplies related to the hospice diagnosis.
Misconception #6: Patient and family must be “ready” to die or accept impending death.
Truth: Hospice is a special concept of care designed to provide comfort and support to patients and their families. Most hospice care agencies acknowledge and provide services to all eligible patients and families at any level of acceptance. Hospice deals with the emotional, social and spiritual impact of the disease on the patient and loved ones. Hospice offers a variety of bereavement and counseling services to loved ones before and after a patient’s death.
Misconception #7: Election of hospice means giving up your physician.
Truth: Most hospice care providers support your choice of physician. In fact, the Medicare election statement to receive hospice care contains an acknowledgment that your attending physician is your chosen physician. The hospice medical director works in conjunction with your attending physician in reviewing the plan of care designed by the hospice care team.
Misconception #8: Hospice provides care only during the last hours of a patient’s life.
Truth: Once the diagnosis is made of a terminal illness or condition with a 6 month or less life expectancy, hospice services can be provided to the patient and their loved ones. The hospice care provided may offer the patient relief from pain and distressing symptoms, as well as emotional, social and spiritual support for the patient and family, together with education and coping skills. These benefits are valuable not only for the patient and their loved ones during the patient’s lifetime, but also for the patient’s loved ones after the patient’s death It is most advantageous to begin hospice care as early as possible.
By Matthew M. Wallace, CPA, JD
Published edited August 6, 2017 in The Times Herald newspaper Port Huron, Michigan as: 8 misconceptions about hospice care