1.What is hospice care and what’s hospice philosophy?

Hospice care is a philosophy of bringing comfort and maintaining quality of life (QOL) and dignity as a person approaches the end of life. Hospice care is delivered wherever you call home.

2. When do I know my loved one is ready for hospice?

Most people will have suffered significant declines from baseline by the time hospice is appropriate. The declines include, but are not limited to, physical/functional declines, cognitive declines, skin integrity declines, and/or multiple infections, such as pneumonia and/or urinary tract infections. In addition to declines, treatment may no longer show benefits, i.e. tumor progression despite treatments. Your provider sometimes will discuss hospice with you.

3. How can hospice help me?

Hospice brings medical care to you. Hospice team includes physicians and sometimes nurse practitioners depending on the agency, nurses, healthcare aides, social workers, spiritual care coordinator, and bereavement coordinator. Some agencies also provide music therapist and/or massage therapist. Hospice not only provides care to the patients but also provides emotional care to the family.

4. What’s the difference between palliative care and hospice? (this is where the chart may be helpful)

Palliative care provides symptom management and patients can obtain palliative care in addition to other medical services. Palliative care providers are experts at symptom management and are most beneficial as adjunct to oncology and radiation services. Hospice care also provides symptom management but is provided when a person’s life expectancy is estimated at less than 6 months. Patients who are on hospice generally no longer obtain care from their oncologists.

5. Who pays for hospice?

Medicare and/or Medicaid pays for hospice. Some commercial health insurances also pay for hospice benefits. Hospice care is completely free to the patient and the family.

6. Who qualifies for hospice?

Anyone with a prognosis of 6 months or less with justifiable declines (please refer to questions, “when do I know my loved one is ready for hospice”)

7. How should I choose a hospice agency?

Choose a reputable hospice agency. Interview a few if possible. Pick the hospice team that feels right for you but as a general rule of thumb, an agency that provides the most services usually means that they have more resources which may benefit you more.

8. What if my loved one outlives the 6 months prognosis?

Hospice philosophy aims to maintain patient’s QOL for as long as possible and for as well as possible. If a patient outlives the 6 months prognosis, a physician or nurse practitioner will perform evaluation every 2 months after the initial 6 months to determine ongoing eligibility.

Q&A provided by Wenny Lee, DNP, APRN, FNP-BC, ACHP