What to Expect from Hospice Care Services

Hearing the word hospice can feel like a door closing. For most families it turns out to be the opposite. Hospice brings a whole team to your side, eases pain and fear, and gives your loved one the chance to spend their time the way they want to, often at home.

What hospice actually is

Hospice is care for people with a serious illness who are no longer seeking treatment to cure it. The focus shifts to comfort: controlling pain and other symptoms, supporting emotional and spiritual needs, and helping the whole family through a hard season.

Most hospice care happens wherever the person lives, whether that is their own home, a relative's home, an assisted living community or a nursing home. Some hospices also have inpatient units for times when symptoms are hard to manage at home.

Who qualifies

Under Medicare, a person qualifies when a doctor certifies that, if the illness runs its usual course, life expectancy is six months or less. That is an estimate, not a deadline. Many people receive hospice longer than six months, and some improve and leave hospice altogether. Your loved one can also stop hospice at any time and return to treatment.

The hospice team

• Nurses visit regularly, manage symptoms and are on call around the clock.
• Hospice aides help with bathing, dressing and personal care.
• A hospice doctor works with your loved one's own doctor on the care plan.
• Social workers help with paperwork, planning and family stress.
• Chaplains offer spiritual support for any faith, or none.
• Volunteers can sit with your loved one so you can rest or run errands.
• Grief counselors support the family, often for about a year after a death.

What is usually covered

Medicare, Medicaid and most private insurance cover hospice. The Medicare benefit generally includes the care team, medicines for pain and symptoms related to the illness, medical equipment like a hospital bed or wheelchair, supplies, short term inpatient care and short respite stays that give family caregivers a break. Room and board in a nursing home or assisted living is usually not covered by the hospice benefit, so ask about that separately.

How to choose a hospice

• How quickly can you start care, and how often will the nurse visit?
• What happens if we call at 2 a.m.? Who answers, and how fast can someone come?
• Do you offer continuous care at home during a crisis?
• Do you have an inpatient unit, or which facilities do you use?
• What support do you offer family members, before and after?

You can compare hospices on Medicare's Care Compare website, which shows family survey results for each provider.

Next steps for your family

If you think it may be time, talk with your loved one's doctor and ask for a hospice evaluation. It does not commit you to anything. Many families say the same thing afterward: they wish they had called sooner.