by David Bynon, last updated

What is Hospice Care?

Hospice is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the patient’s medical, physical, social, emotional, and spiritual needs. Hospice also provides support to the patient’s family or caregiver as well.

Hospice Care at Home

Many people wish to spend their final days at home, not in a hospital or assisted living facility. To do that, they need an increasing amount of medical care as they approach their time to pass. While home health care aides may provide some care, there’s some care only those with medical experience and knowledge can provide. The combination of care from home health aides and nurses is what creates hospice care at home.

Medicare covers almost all aspects of hospice care. In fact, there’s very little cost to patients, so as long as you use a Medicare-approved hospice program. To qualify, you must be eligible for Medicare Part A and your doctor must certify that you are terminally ill and have six months or less to live. These are your costs if you have Original Medicare:

  • You pay nothing for hospice care.
  • A copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you’re at home.
  • You may need to pay 5% of the Medicare-approved amount for inpatient respite care.

In this MedicareWire article, we’ll cover what you can expect from hospice care at home and how Medicare covers it.

When Can Hospice Care Begin

When a doctor recommends hospice care due to a terminal illness (death is expected in 6 months or less), hospice care at home can begin. This doesn’t mean there is a guarantee the person will die in the next six months. If the person outlives the six months, another six months may be recommended by the treating physician.

The Four Levels of Hospice Care

There are four levels of hospice care:

  1. Routine Hospice Care – This type of hospice care includes nursing and home health aide services.
  2. Continuous Home Care – This level provides nursing care services on a continuous basis during a crisis.
  3. General Inpatient Care – A nurse or physician provides services just as the person would receive in a hospital setting.
  4. Respite Care – Caregivers get a break by having a home health aide or nurse come to the home to take care of the person.

The levels of hospice care change as needs change. Routine hospice may turn into continuous, or respite may turn into a routine level, etc.

What to Expect with Hospice Care

Hospice care services depend on needs and desires. Depending on the home health agency’s hospice care services, people can receive the following services while at home.

  • Religious services
  • Counseling
  • Pain medication
  • Medical equipment and supplies
  • Nutrition coaching
  • Physical therapy

Each person receives a personalized treatment plan with a schedule of services. The appropriate professional will come to the home to provide the services.

What It Means to Have Hospice Care

Hospice care means the person under care has decided not to go to the hospital for emergency care if the need arises. If the person decides to go to the hospital, hospice care ends.

Hospice care can be reinstated after the person comes back home, but the person would have to get started with the process again. This includes getting the recommendation from the doctor and completing the paperwork to restart services.

Getting Started with Hospice Care

If you or your older loved one has decided hospice care would be best, the first step in getting hospice is speaking with your doctor. The doctor will review your medical history and current medical condition to determine if you have a terminal illness. The doctor will write a recommendation for hospice care if it is appropriate at this time. From there, you can start working with a home care agency to start hospice care.

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