Guidance And Support

Hospice is a guide through the end-of-life experience. As advisors and advocates, we help patients and their families navigate the details of an unfamiliar and emotionally challenging process.

Hospice care focuses on the comfort, quality of life, and dignity of people who are terminally ill. Hospice teams include doctors, nurses, social workers, and home health aides, all with specialized training for the following services:

• Physical care
• Emotional and spiritual support
• Social support
• Therapy services
• Advance care planning

Hospice is not a medical care provider. Our role is as an advocate to the patient and their wishes. We educate and support caregivers in providing care accordingly. We consider the holistic portrait of the patient’s wellbeing, their family, and spirituality, to ensure that medical approaches align with goals for treatment.

No, hospice does not typically include custodial care of day-to-day tasks, such as eating, bathing, and cleaning. Instead, hospice care complements the work of caregivers, in-home or at a senior living community. Many providers, however, do have relationships with 24-hour on-call nurses that can respond to pain management needs.

Hospice can provide 24-hour care in some unique situations, such as when a patient is experiencing uncontrollable symptoms (pain, difficulty breathing, or nausea) or acute symptoms that can't be managed by the primary caregiver. The cost is determined by the patient's insurance coverage. While Medicare covers 24-hour hospice care, it may not cover all expenses.

Hospice can be provided in many settings – in a private home, senior living community or hospital. The setting is often determined by how much care the individual needs and if this is provided at a community, by paid caregivers, or by family.

Explore hospice early, as it may result in months of rich quality time, alleviated stress, and meaningful care for loved ones.

Assisted living and nursing homes typically provide personal care services, nursing care, and rehabilitation services. Their staff are the primary caregivers for their residents. A patient not living in a community may have a different caregiver, whether that be a family-member or home care aide. Hospice is a patient advocate and life-planning service that plays an advisory role to whoever the patient’s primary caregiver is.

Hospice care is primarily paid for through Medicare, which covers the majority of costs for eligible patients. Most people with Medicare won't have any out-of-pocket expenses for hospice care. Other options include private insurance plans and Medicaid, depending on individual eligibility and state regulations. Commonheart offers financial assistance for individuals without insurance or with limited means.

We provide a free, non-obligatory, introductory meeting and information session to learn what matters holistically to the patient and their family. Questions include:

• What misconceptions or fears do you have?
• What does your support structure look like?
• Who are people involved in your care that you want included in conversations?

In addition to managing symptoms of the patient's illness, hospice supports families and loved ones by providing emotional support, bereavement care after death, and a dignified environment in which patient and family can focus on quality time during final days.

Life planning decisions are best navigated in a calm state of mind. Waiting until a patient sees their own need may also mean letting their decline progress in ways that could be prevented with earlier discussion. Encourage your loved one to consider hospice, before physical, mental, or emotional challenges limit their ability to share final wishes and fully engage in life planning discussions.

Be a supportive presence and encourage their agency in decision-making. End-of-life care is something they’ve earned by way of a rich and full life. They will feel more confident and empowered to make it a comfortable and peaceful experience according to their own wishes with your support.

Humans maintain a strong will to live. There may be resistance to acknowledging the inevitable. This is especially true among adults who still have ambitions or unresolved feelings about their past, spirituality, or relationships. This may impact how receptive they are to having end-of-life discussions. It’s important to acknowledge hesitations. You don’t have to resolve everything before taking the step towards hospice. In fact, hospice exists to help you and your loved ones navigate challenges so you can find clarity together.

Each individual insurance policy differs. However, yes, Medicare, Medicaid, and most other policies stipulate that a patient must be certified as terminally ill (having a life expectancy of six months or less) by a physician, and accept palliative care instead of curative treatment in order for hospice care to be covered by insurance.

When someone is diagnosed with a life-threatening chronic or terminal condition, that is the time to encourage patients to think about their future.

The administration of morphine or any other medication depends on the individual needs and symptoms of the patient. Morphine may be used in hospice care to manage severe pain and shortness of breath, but it is not given to all patients receiving hospice services.

To qualify for hospice coverage, most insurance plans will require discontinuation of treatments specifically intended to cure or control the terminal illness. However, a person in hospice can continue to take medications to treat other health conditions unrelated to their terminal illness.

Our role is to guide patients in making decisions that align with their personal health goals to increase quality of life. If a patient finds that side effects from their medications do not align with their goals, a hospice provider may consult with a doctor on alternative medication plans.

The patient, or their designated healthcare decision-maker, always retains the right to make decisions regarding their care. What hospice can do is provide recommendations, educate on and discuss options, and advocate for patient needs.