What is Hospice Care and Who Pays for It?

Understanding Hospice Care

Hospice care is care that is focused on making sure that people in the last stages of incurable diseases are able to spend their remaining days as comfortably and meaningfully as possible. The focus is on enhancing quality of life rather than prolonging its length.

As a general rule, people are accepted into hospice care when their doctors acknowledge that treatment aimed at curing their disease will no longer be helpful to them, and they would, if the illness progresses as expected, have less than six months to live. The decision to enter hospice care is made by a patient and their family with a doctor's help.

Many people delay the decision to enter hospice because they feel that it means "giving up." However, you can go into hospice and then choose to leave and begin actively treating your illness again at any time, re-entering hospice only when you are ready. When asked, many patients and families who have experienced hospice care say they wish they had begun hospice sooner, not later.

Who Provides Hospice Care?

Care is provided by an interdisciplinary team that includes the patient's family or loved ones, doctors, nurses, counselors, social workers, health care aides, clergy, and volunteers. The professionals and volunteers assisting the family all have special training in end-of-life-care.

Hospice care is often provided at home, but may also be provided at a hospital, nursing home, or separate hospice facility. Symptom relief is a primary focus of care, along with providing social, emotional, and financial support. The hospice professionals keep family informed and provide the training necessary for them to care for the patient. They may also provide respite care so family caregivers can get a break for a few days, and bereavement care to support the family for months after the patient's death.

Who Pays for Hospice Care?

Considering the level of support hospice offers, you might reasonably be concerned about cost. While it's true that hospital or facility-based hospice care is usually more expensive than home hospice care, because of the lack of costly interventions, it may still be less costly than expected.

In addition, Medicare and Medicaid typically cover hospice services, as does the Department of Veterans Affairs. Most private health insurance plans and HMOs also cover hospice. For those who are uninsured or otherwise can't afford to pay, private donations allow hospice organizations to provide free or reduced-cost care. If you are concerned about the cost, contact a hospice organization, where financial support staff can answer your questions and help you coordinate resources to pay for the cost of care. Most families who have received hospice assistance do not find the cost burdensome, and almost all are grateful hospice care was available.

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