Hospice: FREQUENTLY ASKED QUESTIONS
- How is hospice different from other medical care?
- How is VNS Hospice of Central Indiana different from otherhospices?
- What services do you provide?
- Doesn't accepting hospice mean giving up?
- What specific assistance does VNS Hospice provide home-based patients?
- Is the home the only place hospice services are delivered?
- Who pays for hospice care?
- What are the different levels of hospice care?
- When should patients and families consider hospice care?
- Should family wait for our physician to raise the possibility of hospice, or should I raise it first?
- What if my loved one chooses hospice care and then live more than six months?
- What if my condition improves?
- What kinds of emotional and spiritual support does hospice provide?
- How many family members or friends does it take to care for a patient at home?
- Must someone be with a patient at all times?
- How difficult is caring for a dying loved one at home?
- Does hospice do anything to make death come sooner?
- How does hospice "manage pain"?
- What is VNS Hospice's success rate in battling pain?
- Will medications prevent the patient from being able to talk or know what is happening?
- How will pain medications effect the patient?
- Is VNS Hospice affiliated with any religious group?
- Is hospice covered by insurance?
- If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?
- Does hospice provide any help to the family after the patient dies?
- If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Back to Top How is hospice different from other medical care?
Some of the ways that hospice is different from standard medical care are:
- Hospice provides palliative care-care that focuses on the patient's comfort and quality of life, when curing the disease is not a realistic possibility rather than curative care that focuses on healing the patient.
- Hospice looks at all the patient's and family's needs. A coordinated team of hospice professionals, assisted by volunteers, works to meet the patient's and family's emotional and spiritual needs, as well as the patient's physical needs.
- The emphasis is on controlling pain and symptoms through the most advanced techniques available and on emotional and spiritual support tailored to the needs of the patient and family.
Hospice recognizes that a serious illness affects the entire family as well as the person who is ill. The family, not just the patient, is the "unit of care" for hospice professionals. Sometimes other family members actually need more attention than the patient.
Back to Top How is VNS Hospice of Central Indiana different from other hospices?
Ways that VNS Hospice of Central Indiana is different include:
- The VNS Co-Medical Directors will make home visits when necessary
- Dr. Greg Grammelspacher, VNS Co-medical Director is Board Certified in Palliative Care
- Dr. Neil Irick, VNS Co-Medical Director is internationally known for his work with medicine and pain management
- We have certified Hospice/Palliative Care nurses
- We deliver medication directly to your home
- We are a not-for-profit, United Way Agency
- We are affiliated with Witham and have contracts for hospice care at all three Community Hospitals , Riverview, Putnam, Winona and Wishard Hospital . We also have contracts with multiple care facilities. All this makes additional or higher level medical attention easier to arrange.
Back to Top What services do you provide?
Hospice includes the services of an interdisciplinary team of health care professionals:
- Physicians (the patient's own physician and hospice physicians, who are specialists in controlling pain and other symptoms of serious illness) prescribe medications and other methods of pain and symptom control.
- Nurses are experts at maintaining patient comfort. They assess the patient frequently and help family members provide the necessary support.
- Certified home health aides that provide personal care and help the patient and family with activities of daily living. They also provide companionship and valuable emotional support.
- Social workers coordinate community resources and help the patient and family with non-medical concerns. They can help family members mend damaged relationships, plan for the future and ease other emotional difficulties.
- Chaplains to help patients and families cope with spiritual questions and concerns at the end of life, either directly or by coordinating services with the patient's and family's spiritual advisors.
- Bereavement coordinators help patients and families deal with grief. Grief support services continue for at least one year after the death of a hospice patient.
- Volunteers provide companionship and emotional support and offer help in myriad ways.
Hospice also provides medications, medical equipment and supplies necessary to promote comfort at home or in other hospice settings.
Back to Top Doesn't accepting hospice mean giving up?
The truth is that when patients are admitted to hospice in a timely manner their quality of life and that of their families is greatly enhanced!
Back to Top What specific assistance does VNS Hospice provide home-based patients?
Hospice patients are cared for by the VNS team of committed professionals and volunteers trained in the care and support of terminally ill patients and their families. The Hospice team provides doctors, nurses, a social worker, home health aides, clergy, therapists and volunteers-and each provides assistance based on his or her area of expertise.
Back to Top Is the home the only place hospice services are delivered?
VNS Hospice of Central Indiana promotes quality of life in the comfort of one's own home, where people most want to be when they are ill. However, hospice care can also be provided in a hospital, in a skilled nursing facility or in a hospice-managed residence.
Back to Top Who pays for hospice care?
Hospice is covered by most insurance plans, including Medicare and Medicaid, with few out-of-pocket costs to the patient.
The Medicare hospice benefit covers costs related to the terminal illness, including the services of the hospice team, medication, medical equipment and supplies. Medicare reimburses for different levels of hospice care recognizing that sometimes patients require special attention.
In general, coverage includes:
- Physician services
- Nursing care
- Medical appliance and supplies as appropriate. The physician and nurse will work with the family to determine which medical supplies and equipment the patient needs. VNS Hospice of Central Indiana will order the equipment and have it delivered to the home.
- Drugs for symptom management and pain relief. VNS Hospice of Central Indiana will order the medications for you and deliver them to your home or and you can get them from the pharmacy. Medications for a condition not related to the terminal illness-allergy medication, for example-are not covered by the hospice benefit.
- Short-term inpatient respite care
- Homemaker services and home health aid
- Physical and other therapies
- Counseling
Medicaid is available in 42 states and most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
Back to Top What are the different levels of hospice care?
Most hospice patients live at home or in a nursing home. Routine home hospice care covers the services, of the interdisciplinary hospice team, medications and equipment. Other categories of care are available when needed.
- Inpatient Care. Sometimes pain or symptoms cannot be controlled at home, and the patient is taken to a hospital or other inpatient care center. When the symptoms are under control, the patient returns home. Insurance usually covers the cost of inpatient room and board.
- Respite Care. Many patients have their own caregivers, often family members. When caregivers need a rest from their care giving responsibilities, patients can stay in a nursing home or hospice residential care center for up to five days. Medicare covers the cost of room and board, as do many other insurance plans.
Continuous care. Sometimes a patient has a medical crisis that needs close medical attention. When this happens, we can arrange for inpatient care, or VNS Hospice of Central Indiana can provide round-the-clock care in the home. When the crisis is over, the patient returns to routine home care.
Back to Top When should patients and families consider hospice care?
At any time during a life-limiting illness, it's appropriate to discuss all of 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 an all-out effort to "beat" their disease. Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.
Back to Top Should family 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 healthcare professionals, clergy or friends.
Back to Top What if my loved one chooses hospice care and then live more than six months?
Hospice care does not automatically end after six months. Medicare and most other insurers will continue to pay for hospice care as long as a physician certifies that the patient continues to have a limited life expectancy.
Back to Top What if my condition improves?
If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive therapy or go on about his or her daily life. If a discharged patient should later need to return to hospice car, Medicare and most private insurance will allow additional coverage for this purpose.
Back to Top What kinds of emotional and spiritual support does hospice provide?
Hospice recognizes that people are more than a collection of symptoms. People nearing the end of their lives often face enormous emotional and spiritual distress. They are dismayed as their physical abilities begin to fail. They don't want to be a burden on their families. They worry how their loved ones will manage without them. Sometimes, they feel deep regret about things they have done or said - or things left undone and unsaid. Hospice professionals and volunteers are trained to be active listeners and to help patients and families work through some of these concerns so that they can find peace and emotional comfort in their final days.
Back to Top 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 prepare an individualized care plan that will, among other things, address the amount of care giving a patient needs. Hospice staff visit regularly and are always accessible to answer questions and provide support.
Back to Top Must someone be with a patient at all times?
In the early weeks of care, it's usually not necessary for someone to be with the patient all the time. Later, however, since one of the common fears of patients is the fear of dying alone, hospice generally recommends someone be there continually.
While family and friends must be relied on to give most of the care, VNS Hospice does provide volunteers to assist with errands and to provide a break and time away for major caregivers.
Back to Top How difficult is caring for a dying loved one at home?
It's never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. So, VNS Hospice has staff available around the clock to consult with the family and to make night visits if appropriate.
Back to Top Does hospice do anything to make death come sooner?
Hospices do nothing to either speed up or slow down the dying process. Just as doctor's and midwives lend support and expertise during the time of a child's birth, so hospice provides its presence and specialized knowledge during the dying process.
Back to Top How does hospice "manage pain"?
VNS Hospice is up-to-date on the latest medications and devices for pain and symptom relief. VNS Co-Medical Director, Dr. Neil Irick, is world renown for his work in pain management. In addition, physical and occupational therapists assist patients to be mobile and self-sufficient as possible.
Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain, so it addresses these, as well. Clergy are available to assist family members as well as patients.
Back to Top What is VNS Hospice's success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
Back to Top Will medications prevent the patient from being able to talk or know what is happening?
Usually not. It is the goal of VNS Hospice to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, hospices have been very successful in teaching this goal.
Back to Top How will pain medications effect the patient?
When morphine and other pain control medications are administered properly for medical reasons, patients find much-needed relief without getting "high" or craving drugs. The result is that hospice patients often remain more alert and active because they are not exhausted by uncontrolled symptoms.
Back to Top Is VNS Hospice affiliated with any religious group?
No. VNS is non-profit United Way agency.
Back to Top Is hospice covered by insurance?
Hospice coverage is widely available. Hospice is provided by Medicare nationwide. When a Medicare-eligible patient receives services from VNS Hospice, Medicare pays almost the entire cost. In general, coverage includes:
- Physician services
- Nursing care
- Medical appliance and supplies as appropriate
- Drugs for symptom management and pain relief
- Short-term inpatient respite care
- Homemaker services and home health aid
- Physical and other therapies
- Counseling
Medicaid is available in 42 states and most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider. Back to Top If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?
We do have availability of using United Way funds as long as the patient financially qualifies.
Back to Top Does hospice provide any help to the family after the patient dies?
Hospice follows the family in our bereavement program for 13 months after the patient dies.
Back to Top
If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Although the hospice CAN charge 5% for medications and "Respite Care", VNS Hospice of Central Indiana chooses no to do that.
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