Hospice -- Frequently Asked Questions

National Hospice and Palliative Care Organization

Will I have my own hospice team and how often will they visit?

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

All visits, however, are based on the person and family needs as described in the care plan and the condition of the person during the course of illness. The frequency of volunteers and spiritual care is often dependent upon request and the availability of these services. Travel requirements and other factors may cause some variation in how many individuals each hospice staff serves.

Is hospice available 24 hours a day, 7 days a week?

Hospice care is available 'on call' after the administrative office has closed, seven days a week, 24 hours a day. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well.

What do hospice volunteers do?

Hospice volunteers are generally available to provide different types of support to individuals and their loved ones including running errands, preparing light meals, staying with a person to give loved ones a break, and lending emotional support and companionship to individuals and loved ones.

Because hospice volunteers spend time in homes, each hospice program generally has some type of application and interview process to assure the person is right for this type of volunteer work. In addition, hospice programs have an organized training program for their volunteers. Areas covered by these training programs often include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss and grief and bereavement support.

What happens if I can't be cared for at home?

A growing number of hospice programs have their own hospice facilities or have arrangements with nursing homes, hospitals or inpatient residential centers to care for people who cannot be cared for at home. However, the cost to live in these settings may not be covered by your insurance so it is best to find out if insurance covers this type of care before you call hospice.

Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?

Hospice services can be provided to a person who has a life-limiting illness wherever they live. This means a person 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 for the hospice to serve residents of the facility.

Do state and federal reviewers inspect and evaluate hospices?

Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.

How can I find out if a hospice provides excellent care?

Many hospices use tools to let them see how well they are doing in relation to quality hospice standards. To help hospice programs in making sure they give quality care and service, the National Hospice and Palliative Care Organization (NHPCO) has developed recommended standards entitled 'Standards of Practice for Hospice Programs' as one way of ensuring quality. NHPCO also offers hospices a tool to do a self-evaluation of their program compared to the NHPCO Standards. Ask the hospice when they last completed a self-assessment using the NHPCO Standards.

In addition, most programs use family satisfaction surveys to get feedback on their services and make improvements. Ask the hospice to share a summary of their family satisfaction scores for the last several months with you. You can also ask them if they participate in the national Family Evaluation of Hospice Care. If they do, they should be able to provide you with a summary that compares their scores with the national average scores.

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