1.  When and who should make a decision about entering hospice?
At any time during a life-limiting illness, it is appropriate to discuss all of a patient’s care options, including hospice. By law, the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff, sensitive to these concerns, is available to discuss them with the patient and family.

2.  Should I wait for the physician to raise the possibility of hospice?
The patient and family should feel free to discuss hospice care with their physician, other health care professionals, clergy or friends.

3.  What if our physician doesn’t know about hospice?
Most physicians know about hospice care; however, more information is available from the Academy of Hospice Physicians, medical societies, state Hospice organizations or the National Hospice Helpline (800) 658-8898. There’s also information from the American Cancer Society, AARP, and the Social Security Administration.

4.  Can a hospice patient who shows signs of recovery be returned to regular medical treatment?
Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from Hospice of the Calumet Area and return to aggressive therapy. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.

5.  What does the hospice admission involve?
First, we contact the patient’s physician to make sure he or she agrees that hospice care is appropriate. (Hospices have medical staff to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The “Hospice Election Form” states that the patient understands the care is palliative (aimed at pain relief and symptom control) rather than curative, and outlines services available. Medicare information is also presented.

6.   Are changes in the home or special equipment needed?
Hospice will assess the needs and make the arrangements to obtain the necessary equipment. In general, we will assist in any way we can to make home care as convenient and safe as possible.

7.  How many family members or friends are needed to care for a patient at home?
There is no set number. Our hospice team will prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice personnel visit regularly and are always accessible to answer medical questions and provide support.

8.  Must someone be with the patient at all times?
In the early weeks of care, it is usually not necessary. Later, however, since one of the most common fears of patients is that of dying alone, we generally recommend that someone be there continuously. While family and friends do deliver most of the care, Hospice provides volunteers to assist with errands and to provide a break and time away for caregivers.

9.  What specific assistance does hospice provide home-based patients?
A team consisting of a doctor, nurses, social workers, counselors, home health aides, clergy, therapists and volunteers cares for hospice patients. Each provides assistance based on an area of expertise. Hospice also provides medications, supplies, equipment, hospital services and additional helpers in the home, if and when needed.

10. Does hospice do anything to make death come sooner?
Hospice neither hastens nor postpones the dying process. Just as doctors and midwives lend support and expertise during the time of birth, the hospice team provides its presence and specialized knowledge during the dying process.

11. Is caring for the patient at home the only place hospice care can be delivered?
No. Although 90 percent of Hospice patient time is spent in a personal residence, some patients live in assisted living, nursing homes or hospice centers.

12. How does hospice “manage pain?”
Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain, so it addresses each. Hospice doctors and nurses are up-to-date on the latest therapies for pain and symptom relief. Physical and occupational therapists may assist patients to be as mobile and self sufficient as possible, and they often are joined by specialists schooled in music and art therapy, massage and diet counseling. Counselors of all kinds, including clergy, are available to assist family members and patients.

13. Will medications prevent the patient from being able to talk or know what’s happening?
Not usually. It is the goal of Hospice to allow the patient to be pain-free but alert. By constantly consulting with the patient, Hospice can be successful in reaching this goal.

14. What is Hospice of the Calumet Area’s success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.

15. Is hospice care covered by insurance?
Hospice coverage is available widely, including Medicare nationwide, Medicaid in 39 states, and by most private insurance providers; Hospice of the Calumet Area will check the coverage for each particular situation.

16. Is hospice affiliated with any religious organization?
No. While some churches and religions have started hospices (sometimes in connection with their hospitals), Hospice of the Calumet Area serves a broad community and does not require patients to adhere to any particular set of beliefs.

17. If the patient is eligible for Medicare, are there any additional expenses?
Medicare covers all services and supplies for the hospice patient. Some hospices require a 5 percent of $5 “co-payment” on medication and respite care. Families should inquire about any additional expenses. Hospice of the Calumet Area does not require any Medicare co-payments.

18. Will Hospice provide care if the patient isn’t covered by Medicare or other health insurance?
The first thing hospice will do is assist a family in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, Hospice of the Calumet Area will provide for anyone who can’t pay by using monetary contributions or memorial and foundation gifts.

19. Does Hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. Most hospices, and other community groups, sponsor bereavement groups and support for anyone in the community who has experienced the death of someone close.

20. How difficult is caring for a dying loved one?
It is never easy and sometimes may be quite hard. At the end of a long, progressive illness, nights especially can be long and lonely. So, hospices have staff available around the clock to consult with the family and make night visits if the need arises.