5 Tips for Finding the Best Hospice Care

Finding the Best Hospice Care Tips

• Assess agency qualifications.
• Ask what patient services are offered.
• Inquire about family support.
• Keep notes.
• Get additional opinions.

At the end of life, hospice care is like a soft blanket, gently embracing a loved one. However, choosing a quality provider involves some preparation. This article will map your course, steering you in the right direction. Here are five points to consider in choosing the best agency.

Hospice Defined

Designed for terminally ill patients, hospice focuses on relieving suffering and maintaining comfort. It's assumed that the recipient cannot be cured. All your loved one's needs are met through a single program.

A patient can receive care in the familiar environment of their home or assisted living facility. They can also obtain services in a nursing home, hospital, veterans' facility, or hospice center, with the benefit of high tech equipment.

Services are available without regard to race, religion, illness, or age. Discrimination is not permitted against those who don't speak English, are members of the LGBT community, or have intellectual or developmental disabilities. Payment is fully covered by Medicare, Medicaid, some HMOs, and most private insurers.

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For your loved one to be eligible, two doctors must certify that they have less than six months to live. After the certification process, you should designate one person as the hospice liaison. This individual needs to be available to make decisions on behalf of your loved one. Hospice staff members will visit regularly, providing customized care. They also remain on call 24/7. Here are quick FAQs about hospice.

Services Available

Most hospices participate with Medicare. Those that do are required to extend the same essential services. However, agencies vary by the additional types of assistance offered.

The medical team usually consists of your primary care doctor, a hospice physician, nurses, home health aides, and a social worker. If needed, your loved one will be treated by physical, occupational, and speech therapists. The presence of clergy is especially reassuring. Trained volunteers provide supplemental services.

The hospice team will design a care plan, targeting symptom management. Pain and physical needs are met with medication, supplies, equipment, and therapy. The staff will do their utmost to give emotional, social, and spiritual support, both to the patient and those who love them. They also coach family members on how best to render care.

If symptoms at home become unmanageable or caregivers need a reprieve, patient transfer to a medical facility may be possible. After a loved one passes, survivors receive comfort through counseling and grief support.

Here's detailed information on how to evaluate hospice providers. Following is a summary.

1. Assess agency qualifications.

For your loved one to be covered by Medicare, the hospice you choose must be Medicare-certified. Also, ask if the clinical staff members are certified or credentialed in hospice care. This achievement indicates specialized education and training, targeting the needs of terminally ill patients.

If the agency is accredited, this designation assures delivery of high quality care. Accreditation signifies that a hospice meets rigorous qualifications set by a regulating organization. To become accredited, a facility must first voluntarily apply and pay a fee. Then, it receives onsite visits, proving adherence to established medical practices, policies, and procedures.

Another benchmark of quality is membership in the National Hospice and Palliative Care Organization. This distinction shows conformance to specific standards for hospices.

Agency reliability is further identified by longstanding operation. Consumer Reports advises selecting a hospice with 20+ years of experience and non-profit status. Some families prefer a faith-based hospice or one affiliated with a reputable hospital.

2. Ask what patient services are offered.

All Medicare-certified agencies must render essential services, but many go beyond the basics. Knowing all amenities offered aids in making an informed decision. Some agencies are timely in starting the admission process, and others aren't as prompt. Some hospices have programs tailored to children and patients with specific diseases, such as cancer. Be sure to investigate the following policies:

Freestanding Facilities - Some programs offer temporary residences, such as hospice houses, where patients can live in a home-like setting. However, this type of arrangement isn't covered by Medicare or Medicaid. If you prefer a hospice house, you'll pay out of pocket, unless you have coverage with another insurer.

Response Times - Although you can speak with a staff member 24/7, home care may be limited at certain times. Ask what support is available on nights and weekends and during a crisis. Will staff come to the home, and how quickly? Will the agency send a doctor, nurse, social worker, or clergy? Response times and staff sent vary by hospice.

Pre-Existing Treatments - Make sure a hospice will continue and not limit the treatments your loved one is already receiving. Some services that ease suffering aren't required by Medicare. For example, not all hospices will reduce tumor size with chemotherapy or radiation.

Inpatient Care - Ensure that you're given this option. Some hospices offer inpatient care as a temporary respite for caregivers. Others will relocate a patient to a medical facility when home care becomes complicated. Most agencies don't own inpatient facilities, instead leasing beds in a hospital or nursing home. If inpatient care is offered, visit the medical facility to verify that its location and quality are acceptable. If you prefer a certain hospital or nursing home, ask if the hospice contracts with them.

Continuous Care - When death is imminent, will the agency send a staff member to remain bedside until a patient passes? Will your family also receive support? In some states, a large majority of hospices don't offer 24/7 hands-on care.

3. Inquire about family support.

Respite Care - This service gives a caregiver a reprieve. Although included in hospice programs, find out how often it's given, for how long, and by whom. An agency can opt to provide a nurse, nurse's aide, or trained volunteer. Make sure the arrangement suits you.

Volunteer Services - Find out what tasks volunteers will perform. In addition to companionship, assistance might include personal hygiene, meal preparation, running errands, and light household chores. Also, ask how quickly volunteers can be available.

Bereavement Services - Inquire about grief support given to survivors. Hospices vary in what they offer and may include individual counseling, written materials, outreach letters, and support groups.

4. Keep notes.

Interview more than one hospice to make sure all needs are covered. To prepare, write down your questions in advance. When presenting them, gauge the staff member's attitude and receptivity. Do they appear genuinely concerned or businesslike? Keep a record of your conversations, so you can refer to them later. Here are specific questions to consider asking.

Make sure you won't be charged for the initial meeting with the program representative. You should not be under any obligation to choose a given agency.

Also, if a hospice offers inpatient care and you visit the facility, take notes during your tour. Documentation will facilitate making comparisons and decisions.

5. Get additional opinions.

Ask other family members, friends, and acquaintances if they've had experience with hospice. They may be able to direct you to a reputable agency. Or, your healthcare provider might recommend one. If your loved one is currently hospitalized, the discharge planner may supply you with agencies, and share the hospital's experience with them.

When meeting with a hospice representative, ask if the agency has any quality control data available. Most programs issue satisfaction surveys, to obtain input on program performance. A rep should be able to give you the most recent scores from such questionnaires.

Initiating Care

Once you've decided on a particular hospice, notify your doctor. He or she will contact the hospice program director and make a referral, a formal request. Usually, a program representative visits a patient within 48 hours of referral receipt. Care should begin within two days thereafter. However, for an urgent need, an agency may expedite their admission process.

Finding the Best

All Medicare-certified hospices deliver basic quality care. However, try to locate one that's been operational at least 20 years. Other signs of excellence are accreditation and membership in the National Hospice and Palliative Care Organization.

For any hospice you're considering, find out the specific services offered to patients and families. Document the answers to questions and your impressions of program reps. Then, canvass people with hospice experience, such as your doctor, a discharge planner, family members, and friends. Get their opinions. Also, ask to see the most recent scores from hospice satisfaction surveys.

With some sleuthing, you'll narrow the options down to the best choice. Hospice is highly compassionate care at the end of life.