How hospice works: Part I

When my grandfather enrolled in hospice, my family had a lot of questions. Like many people, we worried about the binary choice between hospice and further curative treatment. We wondered if we were giving up too soon.

But it didn’t feel like giving up. Instead, hospice focused on what my grandpa needed at that stage. They visited at least once a week. They arranged for a hospital bed and other equipment at my grandparents’ apartment to help him get around. When his pain got worse, they walked us through adjusting his medications, including late at night on their 24-hour hotline. And they helped my grandfather die peacefully at home, surrounded by his family.

We’ll be writing more about hospice in Part 2 of this series, but here are some basics:

Q: What is hospice?

A: It’s helpful to think about hospice as both a concept and a service. As a concept, hospice is for people with serious illnesses and the goal is to help you have the best possible quality of life. It’s a way to have medical care outside the hospital that’s focused on keeping you comfortable. As a service, hospice has very specific requirements. For a person to qualify for the hospice benefit, two doctors have to agree that he or she has a life expectancy of 6 months or less. Hospice teams are experts in treating pain and other symptoms and helping you talk about spiritual or social concerns. There’s usually a medical director, nurse, social worker, and chaplain if you want one. You can call the 24/7 hotline and your nurse can visit you at home up to a few times a week depending on your needs.

Q: Where do you get hospice care?

A: For a lot of people, hospice means visits in their own home or a nursing home, but some hospices also have stand-alone buildings, and some hospitals can provide hospice care to patients admitted to the hospital.  Patients in a hospital or stand-alone facility usually require closer monitoring or adjustment of medications.

Q: Who pays for it?

A: Hospice is a benefit that’s paid for by Medicare, the Veterans Administration, or most private insurances.

Q: What is hospice not?

A: Hospice is not 24-hour nursing care. It is also not the same as palliative care,  which has a lot of the same values but is a medical specialty, not a Medicare benefit. You can see a palliative care doctor in a hospital or a clinic without being on hospice.

See the next post in this series for more information on hospice.  Please share any questions you have that you want us to answer in future posts!

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