In the last months of life, the hospice program offers important benefits. These include improved emotional status for the family, major symptom improvement, improved survival, and cost savings. Unfortunately, only half of Americans receive hospice, and three out of four of them get less than the recommended time in hospice. In other words, only one in eight Americans receive the three to six months of hospice services known to achieve the best results for families. There are many reasons for this. Some are unavoidable. In part, common myths surrounding hospice cause this problem that in the end hurts patients and families.
Who Pays for Hospice?
Hospice care is covered by Medicare, Medicaid, the Veteran’s Health Administration, and most private insurers.
According to the National Hospice and Palliative Care Organization, over 85% of hospice patients are covered by the Medicare Hospice Benefit. Hospice care is covered under Medicare Part A (hospital insurance) at 100%, so there is no cost to the patient or their family.
What services are typically covered by Hospice benefits?
Most people receive hospice care through the Medicare Hospice Benefit. Medicaid and the Veteran’s Health Administration follow the Medicare benefit model.
The services that the Medicare Hospice Benefit covers are:
Medical equipment (such as hospital beds, wheelchairs or walkers)
Medical supplies (such as bandages and catheters)
Drugs to control pain and othersymptoms
Home health aide and homemaker services
Social worker services
Emotional and spiritual counseling to help the patient and family with grief and loss
Short-term in-patient care in the hospital, including “respite care”, which is a service designed to provide family members a short break from caring for their loved one at home
Myth #1: Hospice Is So People Can Be At Home When They Die.
Surveys show that most people would prefer to die at home. Hospice makes this possible, but it is a myth that this is the purpose of hospice. This thinking leads to the too-common situation where people are sent home from the hospital to hospice, with days or even hours to live. Rushing someone home to die can be better than spending one’s last day in a hospital unnecessarily, but it’s not hospice.
Hospice Myth #2: Hospice Takes A Patient Out Of The Medical System.
Sometimes, when people discontinue aggressive treatments at large, bustling medical facilities and replace that with comfort care in the peace and quiet of home, it can feel like a major change. However, hospice makes nursing, therapy, personal care, medical equipment, pharmacy services, and more available in a patient’s home. For matters related to the hospice diagnosis, people can still see the doctor who is signing the hospice orders. For other diagnoses, patients can see any other doctor just like normal. If a patient and his or her doctor choose to resume a cure-seeking treatment, the patient can be discharged from hospice care at any time.
Hospice Myth # 3 Choosing Hospice Means Giving Up.
Hospice most certainly is not the same as giving up. Hospice is an important personal choice that patients need to make at the time that is right for them. For some people, the choice may be to continue trying procedures with a very low chance of success, maybe with a higher chance of shortening life, at the expense of comfort and quality of life during the last months of life. For others, hospice means embracing the hope for a higher quality of life. Hospice means people are imagining a better life, with fewer hospital and ER visits, with more time for family and friends, and with less pain.