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Hospice Home Health FAQs
What is interdisciplinary team care?
The team is a group of hospice staff members who coordinate efforts on behalf of the patient and family. Because people have varying physical, psychosocial, social and spiritual components, hospice care is provided by a team in which these disciplines are represented: physician care, nursing, social work, clergy, volunteers, dietary, and physical, occupational and speech therapies. The patient and family are also considered members of the team.
What is a hospice plan of care?
The plan of care outlines the care the patient and family will receive from Beloit Regional Hospice. It includes all aspects of care from each discipline and is agreed upon by the patient.
When is it time to talk to a patient about hospice?
Early in the diagnosis. This gives the patient and family time to evaluate all their options as the illness progresses.
When is it time to refer a patient to hospice?
- When, in your best judgment, the patient has a life expectancy of six months or less.
- When the focus of treatment shifts to comfort care.
- When there is a history of frequent, multiple hospitalizations or emergency room visits.
- When the patient's pain and symptoms require close monitoring.
- When the patient and family need additional physical and/or emotional support.
Is my patient ready?
We know that determining a six-month prognosis for many patients can be a challenge. This is one of the reasons that a Medicare criterion for hospice is a “six-month prognosis, if the disease runs its normal course.” Congress has affirmed that this prognosis is based on the medical opinion of a patient’s attending physician.
Some questions to help you think about whether a patient meets this criterion:
- Would you be surprised if the patient died in the next six months?
- Does the patient have co-morbidities that may further compromise his or her health?
- Is the patient more symptomatic than in the past, despite receiving optimum medical therapy?
- Has the patient experienced recurring infections or complications like pneumonia?
- Has the patient fallen and broken a hip?
- Statistically, over 50% of chronically ill patients who fall and fracture a hip die within a six-month period.
- Has the family mentioned Hospice?
- Often a family caring for a chronically ill loved one is the most insightful to the patient's prognosis. It is vital that their wisdom be acknowledged.
Are you concerned that a potential hospice patient may live longer than six months?
Although this does occur, it will not be a problem if he or she continues to have a likely six-month prognosis throughout their hospice stay. Sometimes, admitting a patient for one benefit period allows a more careful review of eligibility for coming months.
If you have a patient in your care who is demonstrating several of the changes noted above, we can help you assess whether or not hospice care is a possibility.
How will Beloit Regional Hospice keep me involved once my patient is admitted to hospice care?
While your patient is in hospice care, you remain the primary physician and provide leadership within the team of caregivers. Our medical director also provides team input regarding palliative care. Our goal is to keep you as informed, and as involved as you would like to be. We can report to you as frequently as you request. Our hospice standing orders allow us to make changes for the comfort of your patient at hour of the day or night.
Who pays for the medications I order for my patient?
Under the Medicare Hospice Benefit, Beloit Regional Hospice pays for the medications related to the management of the terminal illness. Medications for pre-existing medical conditions are not covered. Private insurance companies may have different drug benefits for hospice patients.
Why does the amount of care received differ from one patient to another?
Each patient and family is involved in deciding how much care they would like to receive from us. We review the services your patient is receiving on our visits and tailor them to their needs and desires. We always provide basic services, which include our staff nurse visits, including on-call availability, social work and chaplaincy services, volunteer assistance, and bereavement care to anyone regardless of their payer source.
What is General Inpatient Care and what do I have to do for my patient?
General Inpatient Care is a hospitalization which becomes necessary when the care cannot be managed by the patient and caregivers at home, or when a hospitalized patient would benefit from additional support, is symptomatic and/or imminently dying. This is an acute level of care stay that is covered under the Medicare Hospice Benefit. The hospice team is required to provide justification for the stay. As is true of any acute care stay, a daily visit by the physician is expected to monitor the patient's condition and provide guidance. A history and physical is required, and daily progress notes and physician orders, including hospice standing orders, are requested.
Why are some medications (Comfort Pak) put in my patient's home when they don't need those medications right now?
Emergencies often arise during the night and on weekends. It is very distressing for your patients and families to have to wait for an hour or two for medication to be ordered, filled and delivered before it is administered, especially when your patient is in crisis. Thus, we provide the family with an emergency kit from medications on our standing orders. It includes small amounts of medications we frequently use for symptom management. The nurse who comes to the home can then promptly deal with the symptoms of the patient.
Can a patient live alone and still receive Hospice care?
People who live alone are eligible for Hospice as long as they are safe, but need to be willing to choose in-home assistance or placement when they can no longer manage.
