Hospice care can be a complex and emotional process but can provide your loved one with as much meaningful care and quality time as possible to improve their quality of life at the end of a terminal illness. Receiving hospice care at home is often the preferred choice of patients as they often feel most comfortable in their own home which can provide added peace.
Main Points
- Hospice care is non-curative medical care for terminally ill patients which focuses on easing pain and managing symptoms to improve quality of life.
- Hospice care can be provided at home, including residential facilities, as well as medical facilities such as hospitals or skilled nursing facilities.
- A primary caregiver is required to be at home 24/7 – this is usually a spouse, family member, or friend – and receives training from hospice staff.
- Medicare usually covers home hospice care.
What is Hospice Care
Hospice care is non-curative end of life medical care for people with terminal illnesses where the goal of care is to alleviate pain and manage symptoms to improve a patient’s quality of life so that they can most comfortably live the rest of their life.
Hospice is different from palliative care which also provides comfort care including symptom and pain management alongside curative treatment to treat the patient’s disease or illness..
Routine hospice care is typically provided at a patient’s home – whether that be a nursing home, elderly facility, or private residence.
To be eligible for hospice care, you must meet certain criteria and symptoms such as:
- A certification by a doctor that you have a life expectancy of 6 months or less,
- Treatment is no longer effective,
- Loss of weight,
- Inability to carry out everyday activities,
- Increased sleep and tiredness,
- Frequent ER visits,
- Recurrent infections,
- Increased progress of the terminal disease.
Can You Get Hospice Care at Home?
Yes. You can get hospice care at your home or residential care facility. While most hospice care can be provided in your home, some types of hospice care may be better provided in a hospital or medical facility.
When is Hospice at Home Not a Good Fit?
Hospice care at home is a great way to provide a comfortable setting for care and to spend time with your loved ones before they pass away. However, there are cases where hospice might be better provided at a medical facility:
- Effective pain & symptom management. While most patients can receive optimal hospice care at home, if the patient’s symptoms and pain cannot be well managed from home, it is better to opt to receive hospice care from a medical facility rather than at home.
- The caregiver’s availability. A loved one is typically the primary caregiver for hospice at home. The primary caregiver needs to be physically, mentally, and emotionally able to provide care for the patient. For some, this may mean reducing work hours or leaving a job, and reducing social activities. If the physical, emotional, mental, or potential financial implications of hospice at home are too much, it is better to look for other hospice care options.
- Does the patient live alone? If yes, it may be better to receive hospice care in a residential care facility (such as an assisted living facility or nursing home) or a hospital rather than home hospice care, as these facilities are typically set up to have staff act as the primary caregiver. That said, if there are other family members or friends who are willing to come live with the patient, hospice care at home may still be a good option.
- Are extra supplies required? Are you financially stable to provide additional supplies that you might need, such as a bedside commode or wheelchair? While Medicare will often pay for some of these supplies if they are considered durable medical equipment, some financial burden may fall on the individual to provide equipment and supplies.
Which Hospice Team Members Will Come to Your Home?
When your loved ones decide to enter hospice care, the first step is to choose a primary caregiver – This is typically a family member or close friend. The primary caregiver will work closely with the hospice team to develop a care plan suited to the patient’s needs and preferences.
The primary caregiver will need to be available for your loved one 24/7 if you have chosen home hospice care for them. In addition to providing hospice specific care, the primary caregiver will usually help with custodial care and assisting the patient with everyday activities.
Hospice staff including hospice doctors, nurses, home health aides, social workers, as well as other healthcare professionals can provide the following hospice services at your home:
- Managing the pain and symptoms of the patient’s illness and creating a treatment plan,
- Sending medications, equipment, and supplies to the patient’s house,
- Specialized therapy sessions,
- Psychological, counseling, emotional, and spiritual counseling,
- Assisting the patient with daily activities and routines like eating, bathing, and clothing,
- Respite care,
- Creating dietary plans for the patient and providing all of this information to the primary caregiver.
By choosing hospice care at home, the hospital team will train the primary caregiver, as they will be responsible for physical care or for calling people to help with your family member. While the hospice staff will not be with the patient at all times, they will be reachable by phone. The hospice nurses will also provide regular visits to your loved one on a regular basis to ensure that everything is in order.
Who pays for Home Hospice Care?
You might be saying to yourself, “How am I going to pay for all of this?”. Thankfully, most of the costs are covered by Medicare, which provides a specified list of treatments suggested by the hospice care team. Some of them include:
- Doctors, nursing, and medical services,
- Medical equipment for pain relief and symptom management,
- Physical therapy services,
- Dietary counseling,
- Social services,
- Medical supplies,
- Grief counseling for your family and your loved one,
- Inpatient respite care (temporary care in nursing homes so the primary caregiver can take some time off or rest).
If you choose home hospice care for your loved one and are currently at, or need to be at, a residential care facility (such as a nursing home or assisted living facility), Medicare does not cover room and board costs.
