When is the right time to ask about hospice?
Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones.

How does hospice care begin?
Typically, hospice care starts as soon as a formal request or a "referral" is made by the patient's doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.

Will I be the only hospice patient that the hospice staff serves?
Every hospice patient has access to a hospice volunteer, registered nurse, social worker, home health aide, and chaplain (also known as the interdisciplinary team). For each patient and family, the interdisciplinary team writes a care plan with the patient/family that is used to make sure the patient and family receive the care they need from the team. Typically, full-time registered nurses provide care to about a dozen different families. Social workers usually work with about twice the number of patients/families as nurses. If needed, home health aides, who provide personal care to the patient, will visit most frequently.

Will the hospice staff be available if a need arises at night or on the weekend?
Homestead Hospice has professional staff regularly scheduled to respond to calls from patients or family members and to make visits at night and on weekends. In addition, physicians are available to the professional staff 24 hours a day, seven days a week.

How does the hospice work to keep the patient comfortable?
Many patients may have pain and other serious symptoms as illness progresses. Hospice staff receives special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. Because keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice. Hospice staff works with the patient's physician to make sure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient's care plan. The care plan is reviewed frequently to make sure any changes and new goals are in the plan.

Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?
Remember, hospice is a philosophy of care, not a place. Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order to serve residents of the facility.

What happens if I cannot stay at home due to my increasing care need and require a different place to stay during my final phase of life?
A growing number of hospice programs have their own hospice facilities or have arrangements with freestanding hospice houses, hospitals or inpatient residential centers to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life when they need extra care. However, care in these settings is not covered under the Medicare or Medicaid Hospice Benefit. It is best to find out, well before hospice may be needed, if insurance or any other payer covers this type of care or if patients/families will be responsible for payment.

What is inpatient hospice care?
While most hospice care is provided at home, ("home" to the patient includes home, apartment, group home, assisted living facility or nursing home) hospice care may also be provided in an inpatient setting. Inpatient hospice care can be provided in either a designated unit called a hospice unit or in a "scatter bed" at a hospital. Hospice inpatient care is available for individuals needing help in controlling pain, their symptoms or for those whose family is in crisis and needing respite. It is usually used for the last two weeks of a person's life. Inpatient hospice care is also appropriate for persons already admitted to a hospital who are actively dying. Inpatient Hospice care always depends on bed availability. Hospice will search for an available bed, call you back, and arrange for transportation if necessary. The Hospice staff tries to arrange for care in the site of your choice, but sometimes beds are scarce or not available.