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Learning that you or someone you love has limited time left to live is difficult, to say the least. However, being diagnosed with a terminal illness does not mean that the rest of a person’s life must be spent in somber uncertainty. Hospice care, or end-of-life care, is designed to keep terminally ill patients comfortable and happy as they live out the rest of their days. Additionally, this form of care helps family members of the terminally ill prepare for the passing of a loved one, and it helps the family to know their loved one is in safe hands.
For the purposes of this section, we will provide an overview of hospice care, including available services, care options, and other topics related to end-of-life care.
Many hospice care facilities use a three-pronged approach for ensuring the comfort of terminal patients. In general, our caring hospice services typically include:
- Advanced pain management: An interdisciplinary team of doctors, nurses, specialists, and assistants develop individualized treatment approaches to help relieve each patient’s physical or psychological symptoms. This is often known as comfort care. For example, a patient may be struggling with mental health disorders like depression or anxiety, or they may have physical ailments like nausea or pain. Staff may provide medication as a form of treatment. Medications used in hospice may include analgesics like acetaminophen or opioids, antidepressants, anti-anxiety drugs, antipsychotics, drugs for treating nausea, sleeping medications, and more.
- Quality of life management: Staff members also work toward improving quality of life for cancer patients and other terminally ill residents. While comfort care is a large part of improving quality of life, staff members will also help patients complete day-to-day functions and keep them feeling comfortable, relaxed, and cared for throughout their hospice.
- Emotional wellness: While it’s important to keep patients feeling comfortable physically, maintaining a patient’s emotional well-being is just as important — if not more so. It’s also important to walk the patient’s family through the process and ensure they, too, are maintaining emotional wellness.
- Bereavement care: Staff members work with patients and their families through spiritual, physical, and psychological concerns, allowing those affected by hospice to remain emotionally prepared both during and after the journey.
Palliative Care vs. Hospice
Both palliative care and hospice care are designed to treat a patient’s emerging symptoms in order to keep them comfortable. However, while hospice is meant for end-of-life care, palliative care can be used for anyone who is recovering from surgery or struggling from a severe condition. For example, a person with heart or liver failure may opt for palliative care to ensure comfort, even though they have not received a terminal diagnosis. Another person may be recovering from a cancer-related surgery and need ongoing care for pain management as they heal.
Hospice Care Options
Hospice care can be paid for through a variety of means, including Medicare, Medicaid, Veterans Benefits, private insurance, or private payment. There is a list of Medicare hospice criteria that patients will have to meet, with the primary being that patients must have a life expectancy of less than six months. Additionally, Medicare will not cover prescriptions for treating the terminal illness; instead, it will cover medications for pain relief and symptom management.
There are a few different kinds of hospice care, which can be done at varying levels at the patient’s home, in their nursing home, or in a hospital setting.
Routine Home Care
Patients can receive routine hospice care at home. A nurse will stop by at set times to provide home care assistance, such as help with cleaning, cooking, bathing, medication administration, and other daily activities. This is typically the most affordable hospice care option available, as patients only pay for services when they need them.
Continuous Home Care
Continuous home care also takes place in the comfort of a patient’s home, but the patient requires much more assistance with daily activities, pain management, and other necessities. Hospice nurses will work in shifts to ensure the patient has 24-hour care in their home.
General Inpatient Care
Inpatient hospice care is aimed toward patients who cannot receive suitable care in any place other than in a hospital setting. Patients in hospice inpatient units receive around-the-clock monitoring from medical staff. When the patient’s health stabilizes, they will typically return to a lower level of care, such as home hospice care.
Respite care services are used as a short-term method for providing primary caregivers, such as a spouse, child, or parent, a bit of time off. A respite care provider will take over the caregiver’s role for as little as a few hours or as long as a week or more. Additionally, respite care can take place in a person’s home, or they may be taken to a healthcare facility or daycare for a length of time.
When Is Hospice Recommended?
There are a few things that can help inform the decision of entering hospice care. The most common include:
The person has been informed by a doctor that they have less than six months to live
The person is experiencing severe physical or mental decline, even though they are receiving medical treatment; they may be losing weight, be unable to perform day-to-day activities, or be losing cognitive function
The person is prepared to stop receiving treatment for a terminal illness, and they choose instead to live more comfortably and go through to the natural progression of their illness
When a person has decided to enter hospice care, the next step involves determining which level of hospice is most suitable for their needs and ability levels.
Hospice Care Costs
Hospice costs will vary depending on the type of care. Routine home care, for example, will be more affordable than continuous home care or inpatient options. However, individuals over 65 can receive hospice care through Medicare if they qualify, though there are some limitations. Private insurance providers may also help cover some of the costs of hospice or respite care, but coverage can vary widely from one provider to another. Those who qualify for Medicaid can also receive coverage for hospice care, and TRICARE and CHAMPVA can cover hospice care for veterans and their beneficiaries.
It is difficult to pin down the exact costs of hospice care when paying out of pocket, but Debt.org shows the amounts that Medicare coverage pays on average. These figures are likely similar to what someone would need to pay without insurance or government assistance:
Routine home care: $193 per day
Continuous home care: $41 per hour
General inpatient care: $744 per day
Respite care: $173 per day