What services does Medicare hospice offer?
Hospice is provided by a Medicare-certified agency that can offer a variety of services. These are carefully coordinated within a plan of care developed by the hospice agency in cooperation with the patient's doctor.
Do services include personnel and equipment?
The specific services provided depend on the patient's particular needs and preferences and can include:
- Medical personnel. A hospice physician, in consultation with a patient's doctor, develops an initial hospice care plan. After the plan is in place, you and the person you're caring for won't see much of either doctor, except for problems other personnel cannot handle. Special hospice nurses are often involved in the initial period of adjustment to hospice care, along with a physical therapist, and a nurse is likely to oversee ongoing care.
- Personal aides. Most of the care someone receives through hospice comes from specially trained hospice aides. Aides monitor her symptoms and perform tasks to make her comfortable, including administering pain relief and other medications. They can also help with simple household tasks, though they don't provide general housekeeping services. An aide comes as often as needed, and toward the end, an aide may spend several hours every day with a patient.
- Counseling. Hospice makes various kinds of counseling available, not only to a patient but also to caregivers and family members. A social worker may be available to help with arrangements and paperwork regarding financial and estate matters and end-of-life decisions. Counselors and clergy are also available to help everyone -- patient and caregivers -- deal with emotional issues.
- Medication and equipment. Hospice provides a patient with any drug she may need -- for pain and other symptom control, sleep, mobility, digestion -- to keep her as comfortable as possible. Hospice provides the medications directly, without the need to go to the pharmacy, get a special prescription, or use insurance coverage. The same is true for medical equipment such as a hospital bed, wheelchair, walker, or the like.
Does hospice provide any relief for caregivers?
Hospice attends not only to a patient but also to the needs of caregivers and family. The physical and emotional toll of caring for someone can become enormous, especially if only one or two people are doing most of the round-the-clock care giving. A special feature of hospice, called "respite care," gives caregivers a break by moving the patient to a special hospice facility where, for up to five days, she gets 24-hour daily care. There can be more than one of these respite periods during a patient's time with hospice. Respite care does not happen automatically; the caregiver or the patient's family must specifically request it from the hospice agency.