Hospice demystified: From qualifications to costs and family support

End-of-life decisions can be challenging, but understanding the medical resources available makes it easier for patients and their families. To shed light on what end-of-life care entails, Deana Morgan, a local hospice care consultant with Compassus, answers common questions about the process, the medical qualifications and the unique services her team provides to the community. Gary Groman from The Globe asked the questions, and Deanna answered:

What is hospice care? Hospice care is end-of-life care meant for individuals dealing with a terminal, life-limiting illness. Rather than seeking a cure, the medical focus shifts to providing the highest possible quality of life, managing pain and helping patients comfortably enjoy their remaining time with family and friends.

What do you need to qualify for hospice? To qualify for the hospice benefit under Medicare or Medicaid, a physician must officially determine that the patient has a life-limiting illness and an expected lifespan of six months or less if the disease follows its normal course.

What are the four different aspects or levels of hospice care? The four levels of care covered by Medicare include regular hospice care provided at home, general inpatient care for severe pain management in a hospital, continuous home care where staff remain in the home for extended periods during a crisis, and respite care to give family caregivers a short break.

Where can hospice care be administered? Wherever the patient calls home, which includes a private house, an assisted living facility, or a long-term care nursing facility.

Can a patient receive hospice if they are actively pursuing a cure? No, if a patient is seeking aggressive curative treatments like chemotherapy, radiation, or surgery, they should utilize palliative care instead, and set hospice care aside for a later time.

How does Compassus differ from other hospice providers? Compassus is a large, nationwide company operating in 31 states that offers patients flexibility if they need to relocate, while simultaneously employing local, hometown staff. They also feature an Angel Watch program that pairs volunteers with patients so they are never alone at the end of life.

What specific medical services does the hospice benefit cover? The benefit covers weekly visits from registered nurses, personal hygiene care from bath aides, social workers to assist with paperwork and resources and chaplains who offer spiritual and emotional support.

Does the hospice benefit also support the patient's family? Yes, the team educates and supports the family, arranges for volunteer assistance to give them time away, and provides a bereavement coordinator to help grieving families for thirteen months after their loved one passes away.

What exactly is respite care? Respite care is a hospice service that allows the patient to stay safely in a nursing facility for up to five days. The hospice program pays for this stay, giving the family members who normally care for the patient a chance to rest or travel out of town.

What does hospice care cost a patient on Medicare? Medicare covers the hospice benefit in full, so the patient pays nothing for these services.

Does Medicare pay for room and board if the patient lives in a nursing facility? No, Medicare does not cover long-term room and board; that must be paid for with private funds or by Medicaid, though the hospice medical services provided inside the facility are still fully covered.

How long can someone remain in hospice care? A patient can remain in hospice for months or even years, as long as the medical director certifies that the patient continues to meet the medical criteria. After the first two 90-day periods, patients are recertified every 60 days.

Can a patient choose to leave hospice care? Yes, a patient can choose to come off hospice at any point in time if they decide they want to seek aggressive medical treatment or surgical interventions.

How does Compassus support military veterans? Compassus contracts directly with the Veterans Administration and is certified through the We Honor Veterans program, which trains staff to give special care and attention tailored to the unique past experiences of veterans.

What should a patient do if they have a sudden medical emergency, like a fall? Patients and families should treat their hospice team like emergency services and call them first before calling an ambulance. If a hospital stay is necessary for something unrelated to the terminal illness, the patient temporarily leaves hospice. At the same time, inpatients can quickly resume hospice services upon returning home.