Hospice is a philosophy of care for people faced with a life-limiting illness. It supports patients who have chosen comfort care with pain and symptom management rather than curative care. Hospice emphasizes the patient's quality of life, and neither hastens nor postpones death. Hospice serves the patient and family while supporting physical, emotional, spiritual and practical needs.
What is hospice?
Who qualifies for hospice care?
Patients whose physicians have given a prognosis of approximately six months or less -- if their disease follows its normal progression -- qualify for hospice care.
What if the patient lives longer than six months?
As long as the physician continues to certify the appropriateness of the patient for hospice care and the patient meets the guidelines, hospice care continues after six months.
How is hospice paid for?
Hospice is paid by Medicare, Medicaid and most private insurance plans.
Where is hospice care provided?
Hospice care is provided in the patient's home, hospital, extended care facility or residential care homes. Your insurance plan provides specific coverage guidelines.
What happens in the first 48 hours of hospice service?
The nurse or social worker visits the same day or within 24 hours of referral. The patient signs an informed consent hospice election and the nurse or social worker reviews financial and insurance information. A complete physical assessment is performed by the nurse, who collaborates with the physician on the hospice plan of care developed with the patient and family. Helpful suggestions are given to the patient and family regarding daily care and comfort measures. A schedule for visits is developed, and the nurse contacts the other services needed.
Does hospice cover equipment and supplies?
Hospice covers basic medical equipment such as hospital beds and wheelchairs, and medical supplies and medications that are directly related to the terminal illness. Items not covered by BJC Hospice include nutritional supplements, and over-the-counter or personal hygiene items such as tissues, lotion and shampoo.
How do we get medicine?
The hospice nurse obtains the medication order from the physician. The BJC-contracted pharmacy provides the medicines that are related to the patient's primary diagnosis and are included in the hospice formulary. A 14-day or less supply is ordered at one time. All new medications require approval from BJC Hospice. The nurse reviews the medication supply with caregivers on home visits to ensure necessary medications are on hand.
Is hospice care provided in a senior living home?
BJC Hospice offers all of the benefits of hospice care to residents staying in a residential care facility, assisted living, intermediate care or skilled nursing facility. Hospice staff members provide instruction to the resident, his or her family, and the facility staff to ensure the resident's comfort. Hospice care complements services provided by senior living home staff by providing additional nurses, home health aides, social workers, spiritual care and volunteer services. Hospice team members attend care planning meetings at the senior living home to coordinate the plan of care with the staff and family.
Does hospice pay for a senior living home?
Room and board in extended care facilities are billed by hospice for patients who have Medicaid.
How often will a nurse visit and how long does the visit last?
Visit lengths vary according to the patient and family needs. Most patients are initially seen by a nurse two to three times per week, but visits may become more or less frequent based on the needs of the patient and family. Visits are approximately 60 minutes long.
What other services may be involved?
Other disciplines who may visit include a medical social worker, chaplain, hospice medical director, physical therapist, occupational therapist, speech therapist, home health aide, homemaker, music therapist, massage therapist, bereavement specialist and volunteer.
What does a homemaker provide?
A homemaker provides light housekeeping or meal preparation to assist the patients in remaining in their homes.
What if we don't want all of the disciplines to visit?
The patient and family are free to decide which services are needed. A nurse, chaplain and medical social worker are the essential services required.
What kinds of things would a volunteer help with?
Volunteers do a variety of things including caregiver relief, errands, reading, making scrapbooks, cooking and housekeeping. BJC Hospice has both adult and teen volunteers to support patients and families.
May the patient have physical therapy, occupational therapy or speech therapy?
A patient may receive therapy to the extent that it would add to the patient's safety and quality of life.
Does hospice have people who stay with the patient overnight?
Hospice is a visiting service and does not provide in-home hourly care. If you are interested in hiring hourly care, our social worker can provide you with resources.
What happens if we have a problem after hours?
BJC Hospice is available 24-hours-a-day, seven-days-a-week. Our phones are answered by an answering service after hours. The answering service pages a triage nurse who returns your call promptly, usually within 15 minutes.
Can we call 911?
We ask that you call BJC Hospice first for all of your urgent needs. We will facilitate any care you might need.
What if the patient needs to go back to the hospital?
By calling hospice first, we might be able to keep the patient from being admitted to the hospital. If we are unable to control the patient's symptoms at home, we will arrange for the patient to be directly admitted to the hospital for symptom management, bypassing long stays in the ER.
What if the patient gets an infection?
Infections can be treated with oral antibiotics if the patient and family desire.
Will the nurse draw blood?
Blood draws can be provided for management of symptoms.
Will the patient keep his or her primary doctor?
Hospice encourages the patient and family to keep their primary physician. The nurse communicates with the primary physician on a regular basis, keeping the doctor updated on the patient's condition and addressing any changes needed on the care plan. The patient may choose the hospice medical director as their primary physician.
What if we decided we don't want hospice anymore?
The patient and family can discontinue hospice care at any time. Hospice will ask you to sign a revocation form if you no longer want hospice services.
What happens at the time of death?
Call BJC Hospice. We will send a staff member to the home, notify the physician, the medical examiner and the funeral home. You do not need to call 911.