When and where is hospice care provided?

When?

You may receive hospice care any time after the diagnosis of a life-limiting illness. The earlier the referral, the more we can help. The most frequent comment we receive from our families is: “You made such a difference. If only we’d known, we would have called you in much earlier.”

We ask the physician, “Given the normal course of the disease, would you be surprised to find the patient no longer alive in six months?” If the doctor can answer that he or she would not be surprised, then the patient is a candidate for eligibility. This does not mean that if the patient is still alive in six months that he or she will be denied services – it merely means that the question of eligibility needs to be asked again. If the patient is still eligible, the patient is re-certified for hospice care. There is no limit to the amount of time a patient may receive hospice services, as long as they are deemed medically eligible. Though patients are often referred to us late in their disease process, we have patients in our care for many months, and sometimes, for years.

Sometimes, a hospice patient’s condition can improve that the medical director can no longer recertify a patient as being medically eligible, so the patient may be discharged from our care. We call this “graduating” from hospice care. In those cases, if the patient or family desires, we can stay in touch and are here for the patient again, if they become eligible at a later date.

Where?

Hospice cares for patients wherever the patient considers home — including their own home, long-term care facilities such as nursing homes, assisted living and retirement communities, and rest homes and hospitals.
We also care for patients in our own beautiful inpatient facility, McCarthy Care Center. Located in Sandwich with 10 private rooms, it is designed for patients who require short-term management and stabilization of acute symptoms.

Who provides hospice care?

Hospices provide care to the patient as well as the entire family unit, as defined by the patient. In order to accomplish this, we employ skilled practitioners from many different disciplines to support the patient, family, and caregiver(s). In coordination with the patient’s physician, our hospice interdisciplinary team (IDT), including our medical director, develops an individualized plan of care specifically designed to meet all of the patient’s needs:

• Medical Doctors (MDs) – One of our medical directors collaborates with the patient’s own physician on an ongoing basis to ensure continuity and quality on all medical issues.
• Nurses – Licensed Registered and Practical Nurses (RNs/ LPNs) specialize in pain and symptom management and provide a wide range of skilled nursing care, including monitoring of the patient’s condition, managing medications and treatments. They are available for consultation and home visits 24 hours a day, with full access to the patient’s electronic medical chart.
• Certified Nursing Assistants (CNAs) and Hospice Aides – Provide hands-on assistance, training and support to the caregiver(s), assisting with the patient’s personal care needs as well as household tasks such as laundry, preparation of a small meals, etc. This support allows the patient and caregiver better quality of time together.
• Social Workers – Provide counseling, support and resources for the emotional, social and practical concerns of patients and families at what is often a time of great change and challenge.
• Spiritual counselors – Work together with the patient and, if desired, the clergy of choice, to provide spiritual counseling and comfort.
• Volunteers – Specially selected and trained to provide companionship and enhance support to patients and families.
• Other medical professionals - as needed, including physical therapists, pharmacists, speech therapists, occupational therapists, dieticians, etc.

Who uses hospice services?

Our hospice serves anyone eligible with any life-limiting illness and those they consider family. We also offer consultative and direct care services to the families of children with terminal diseases under our Pediatric Palliative Care Program. Care is provided to anyone regardless of diagnosis, age, gender, nationality, creed, race, sexual orientation or ability to pay.

Hospice care is not only for bed-bound or homebound patients and hospice cares for patients with a wide variety of diseases and combinations of conditions Among the illnesses our patients have had are cancer, cardiac and respiratory disease, renal disease, neurological illnesses, ALS, AIDS, Alzheimer’s disease, cirrhosis, leukemia, and others.

How is hospice paid for?

HOB is certified by The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and Medicare/Medicaid. Care, supplies, durable medical equipment such as hospital beds, oxygen, and medications related to the terminal diagnosis are covered by Medicare, Medicaid, and most insurance providers.

Hospice is paid for through a specially created Medicare Hospice Benefit, a Medicaid Hospice Benefit, or by most private insurers who have similar hospice benefits. There is generally no cost to the patient for anything related to the terminal diagnosis.

Patients not eligible for Medicare or Medicaid, or who have no insurance hospice benefit should call us to discuss the situation. No one will be turned away or denied our care due to inability to pay or limited resources.

You should know that a hospice patient always has the right to stop receiving hospice services, for any reason. If a patient chooses to stop hospice services, he or she can return to the full Medicare coverage and eligibility that he or she was receiving prior to use of the Medicare Hospice Benefit.