Hospice is end-of-life care that seeks to alleviate the patient’s pain and suffering through the application of medical, emotional, psychological, and spiritual care. Hospice is provided to patients with a life expectancy of six months or less. While other forms of care seek to improve or change specific health issues, hospice seeks to console and comfort the patient while preparing their loved ones for the transition ahead.
View a glossary of hospice care industry terms.
Fast Facts About Hospice Care
- In-home hospice costs an average $142 per day
- In-patient hospice care may cost upwards of $10,000 per month depending on services required
- Medicare pays up to $672 per day for general in-patient, short-term hospice care
- Primary hospice admissions are: cancer (37%), debility (14%), dementia (12.5%), and heart disease (11%)
- Hospice services are funded through: Medicare, Medicaid, private insurance, private funds, and charitable contributions
Source: MedPac.gov (July 2014)
How much does hospice care cost?
The cost for hospice depends on the specific services and needs of the patient, as well as the location where the care is provided. Roughly 64% of patients receive their care at their residence (which can also include their nursing home), while 26% receive their care in a specialized hospice facility. The remaining patients are cared for in acute care hospitals.
Hospice is primarily paid for through Medicare and Medicaid. The Medicare Hospice Benefit, provided through Medicare Part A, enables Medicare patients to receive advanced care for life limiting illnesses. Hospice may also be paid through private funds, long-term care insurance, or through other government programs such as social security or Veterans Affairs.
How to Get Financial Assistance
In order to receive financial assistance, recipients are required to sign a statement electing hospice care and need to show a letter from their doctor showing their life expectancy to be six months or less. Patients are able to receive care regardless of their ability to pay.
For patients using the Medicare Hospice Benefit to pay for hospice, the following items are required:
- A diagnosis letter from the patient’s doctor and the hospice director that the patient has six months or less to live
- A signed statement by the patient to choose hospice care
- Acceptance into a Medicare-certified hospice program
It is important to note that Medicare pays the hospice fees directly to the provider. The patient may be billed up to $5.00 for outpatient prescriptions for pain relief or co-pays and up to 5% for any respite or acute care.
Go over your loved one’s financial situation to determine the next best course of action. Caring Connections has a useful financial inventory print-out that will help you put your loved one’s accounts into order. Also, Medicare.gov offers a valuable guide regarding hospice care.
What services are provided in hospice care?
Hospice utilizes a multi-discipline approach involving doctors, pharmacists, chaplains, psychologists, and social workers who are no longer trying to prolong the patient’s life through proactive measures (such as chemotherapy), but rather, are committed to providing palliative care (such as anti-nausea medication) to enable the patient to remain as comfortable as possible through the final days and weeks of life expectancy.
Hospice is most commonly conducted at the place they call home as the patient is more comfortable with spending their final days in a familiar environment. Hospice can also be provided within specialized in-patient hospice facilities, hospitals, or skilled nursing homes if the patient’s illness has advanced to the point where significant resources are required that cannot be given from one’s home.
Types of Hospice Care Plans
Hospice providers offer a blend of advanced medical care, expert pain management, emotional and mental support, as well as spiritual guidance crafted specifically to the patient’s needs. With input and guidance from the patient’s primary caregiver (typically a family member), a plan of care is developed and implemented by the interdisciplinary team.
The four main types of care provided in the hospice industry include routine home-based care, continuous home-based care, general in-patient care, and in-patient respite care. Home-based care is provided at the patient’s place of residence and can include their nursing home. Continuous home-care is provided by a skilled licensed nurse during a brief episode of crises. The main objective is to provide short-term continuous care in order to keep the patient at home.
General in-patient care is provided in a specialized hospice, hospital, or advanced nursing home. This type of care is provided when the patient needs additional medical resources to alleviate pain that cannot be relieved at home or the nursing facility. In-patient respite care provides temporary relief to the primary caregiver on a short-term basis.
What You Can Expect From Hospice Care
Although the services may vary slightly from one provider to the next, services that are offered typically include:
- Regular home care visits by registered nurses and licensed practical nurses
- Home health aides for personal needs
- Clinical and non-clinical care
- Transportation to and from hospital facilities
- Coordination of visits
- Nutrition counseling (not room or board)
- Dressing and bathing the patient
- Volunteer support
- Administrative duties with billing
- 24-hour “on-call” support
- Pain and symptom management
- Pastoral involvement in the emotional, psychosocial and spiritual aspects of dying
- Speech and physical therapy
- Prescription drugs, medical supplies, and medical equipment (such as oxygen)
- Guidance to family members on caring for the patient
- Short-term in-patient care for immediate care
- Respite for the primary caregiver
- Bereavement counseling and support for surviving family and friends for up to one year