When a doctor says there is nothing more to be done for a patient, it’s time to call hospice.

Hospice is a type of program that provides care and support for terminally ill patients and their family at home. Two physicians must certify that, in their opinion, the patient has an illness that will result in death in six months or less if the disease takes its normal course. Since Medicare mandates hospice care, the government decides the rules for payment.

Hospice care provides

• Physicians on call 24/7 and a case manager, usually a registered nurse, who will visit one to three times a week.
• A home health aide who assists with care, including bathing and linen changes.
• A team of continuous care nurses who will work at the bedside in cases where extreme symptom management is required. They usually work in 24-hour increments, and the patient is reevaluated every 24 hours until the symptoms are under control. This is never a permanent situation.
• A chaplain assigned to each patient. He or she does not take the place of your personal spiritual adviser.
• A social worker to assist with advanced directives and any needs of the patient or family.
• Volunteers to visit with the patient to talk, listen or read.
• Bereavement services for the family for 12-13 months after the death of their loved one.

Who will pay?

Hospice cares for all people diagnosed with a terminal illness regardless of diagnosis, race, nationality, sex, religious affiliation, availability of a caregiver, monetary worth or ability to pay. No one who fits the criteria of a terminal illness and less than six months to live is ever turned away.

The majority of hospice services are paid for at 100 percent by the patient and family through Medicare, Medicaid or private insurance. Be sure to confirm that your hospice choice is Medicare certified if that’s how you’ll be covering care. All medication relating to the terminal diagnosis is paid for under the hospice benefit, as is necessary medical equipment and supplies.

Questions to ask

When the time comes for a patient to enter hospice, the doctor or hospital will recommend a company. Before choosing one, interview two or three. Here are some important questions:

• How long have you been in business?
• Are you Medicare certified?
• What is your nurse-to-patient ratio?
• How many patients do you have on your service?
• Will I be able to get someone to answer my call 24 hours a day?
• Do you have access to staff if we need continuous care nurses?

Every person grieves differently. It’s a good idea to remember when you have hospice care for yourself or a loved one, you are never alone. You have a team of caregivers, who are usually the most compassionate and caring listeners you will ever meet.