When should a decision about entering Hospice be made and who should make it?

The decision belongs to the patient.  It is appropriate to discuss all of a patient's options at any time during a terminal illness.  Understandably, most people are uncomfortable with the idea of stopping an all-out effort to "beat" the disease.  Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.

Should a patient wait for the physician to raise the possibility of Hospice, or should the patient raise it first?

The patient and family should feel free to discuss Hospice care at any time with their physician, other healthcare professionals, clergy and/or friends.  Hospice welcomes questions/concerns about our services.

Can a Hospice patient who shows signs of recovery be returned to regular medical treatment?

If the patient's condition improves and the disease seems to be in remission, patients can be discharged from Hospice and return to active treatment or go on about their daily life.

What is involved in the Hospice admission process?

With the patient's consent, our Patient Care Coordinator will first contact the attending physician to make sure that he or she agrees that Hospice care is appropriate for the patient at this time.  The patient will also be asked to sign consent and insurance forms.  The RN will do an initial admission visit and develop an individualized plan of care for the patient.  Further services will be made available to the patient/family as needed.

Are there any special equipment needs or changes I have to make in my home before Hospice care begins?

Often the need for equipment is minimal at first and increases as the disease progresses.  We will assess needs, recommend any equipment, and help make arrangements to obtain whatever is necessary.  In general, we will help in any way to make home care as convenient and safe as possible.

How many family members or friends does it take to care for a patient at home?

There's no set number, but a primary caregiver is required for a patient to come on service.  The Hospice role is to provide support, education, supplies, equipment and medication to enable caregivers to care for loved ones at home.  The primary responsibility for patient care remains with the family or friends.

Must someone be with the patient at all times?

In the early weeks of care, it's often unnecessary for someone to be with the patient all the time.  As the patient's health declines, it is necessary for someone to stay with the patient more often.

How difficult is caring for a dying loved one at home?

It's never easy and sometimes can be quite hard.  Hospice is there to provide support to the patient/family.  Our RN is on call 24 hours a day.  We can also provide trained volunteers and certified Home Health Aides to provide "respite care", to give family members a break.

What specific assistance is provided to home-based patients?

Hospice patients are cared for by a team representing the needs of the individual patient.  Doctors, nurses, social workers, home health aides, clergy, therapists, and volunteers may each provide assistance based on his or her area of expertise and patient need.  In addition, we provide medication, supplies, and equipment.

Does Hospice do anything to make death come sooner?

We neither hasten nor postpone death.  We support the patient's decisions for treatment and care.

Is caring for the patient at home the only place Hospice care can be delivered?

No, although nearly all Lewis County Hospice patients’ care is provided in their home, we do provide care for patients in the nursing home, and also in assisted living facilities within the county.

How does Hospice "manage" pain?

Hospice nurses and doctors are up to date on the latest medications and techniques for pain and symptom relief.  In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible.  Since we believe that emotional and spiritual pain are just as real and in need of attention as physical pain, we address each.  Our social worker and clergy are available to assist family members as well as patients.

Will medications prevent the patient from being able to talk or know what's happening?

It is the goal of Hospice to allow the patient to be pain-free but alert.  By constantly consulting with the patient, we have been very successful in reaching this goal.

Is our Hospice affiliated with any religious organization?

Neither our Hospice nor the nationwide Hospice movement is an offshoot of any religion.  While some churches and religions have started Hospices (sometimes in connection with their hospitals), Hospices serve all those living in our service areas that are in need of us. 

Is Hospice care covered by insurance?

Hospice coverage is available widely.  It is provided by Medicare nationwide and also by Medicaid in New York State.  Many private health insurance providers also include a Hospice benefit.  Patients remain responsible for co-payments or non-covered charges for illnesses unrelated to the terminal diagnosis.

If the patient is eligible for Medicare, will there be any additional expenses to be paid?

There is a 5 percent or $5 co-pay (whichever amount is less) for all medications related to the terminal illness regardless of other prescription drug coverage.

If Medicare or any other health insurance does not cover a patient, will Hospice still provide care?

We will assist families in finding out whether the patient is eligible for any coverage they may not be aware of.  Services are also available on a sliding fee scale for those who do not have insurance coverage.  Hospice does not refuse service to anyone based on their ability to pay.

Does Hospice provide any help to the family after the patient's death?

We provide continuing contact and support for family and friends for thirteen months following the death of a loved one.  What is provided depends on the needs and wishes of surviving family and friends.