Hospice provides care and comfort to patients diagnosed with a life limiting illness that has been certified as terminal by a physician. Hospice is provided through a team-oriented approach to medical care, pain management, and emotional and spiritual support. The care plan is developed and tailored to each patient’s needs while supporting family wishes. Hospice focuses on caring for the patient and family, rather than curing the disease. In most cases, hospice care is provided in the patient’s home.

• Provided in the patient’s home, freestanding hospice centers, hospitals, nursing homes and other long-term care facilities. The majority of hospice patients are cared for in their own homes or anywhere home may be.
• Available to patients of any age, religion, race, or illness.
• Covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.
• For any person who has a life-threatening or terminal illness with a prognosis of six months or less if the illness runs its normal course.
• For patients with both cancer and non-cancer illnesses.
• Available for the patient and their family facing an end-of-life illness. Hospice assists by providing palliative care services for our patients, and education and counseling for the family.
• Available 24 hours a day, seven days a week through hospice staff that are on-call.
• Typically covered by Medicare, Medicaid and some private insurances when the expense is related to the terminal diagnosis. This includes medications, supplies, durable medical equipment and nursing services.

There are four levels of hospice care, that is covered by Medicare, Medicaid and most insurance plans. They allow the hospice to keep the patient in the setting that best meets the needs of the patient. Some or all of these levels of care may be utilized during a patient’s time on hospice.

• Routine Care: Physicians, nurses, certified nurse aides, chaplains, social workers, and other members of our team are available to assist with providing comfort care and symptom management in the patient’s home.
• General Inpatient Care: When acute pain and chronic symptoms require more than routine care, the patient is moved to a hospice contracted facility with 24/7 registered nurses on site. This short-term benefit assists to comfort the patient and family with changes in medical treatment before being released back to their home.
• Inpatient Respite Care: This service is often used to provide a break so that caregivers can participate in other family activities, such as holiday celebrations, or just to relieve a tired caregiver for a few days. We will take care of the patient for up to five days.
• Continuous Care: When pain or symptoms reach a crisis, patients receive treatment for a brief period; medical staff are on hand to help manage these symptoms until they are controlled.

The hospice or the attending physician determines what levels of care are needed, and all types of care must be approved by the hospice before the patient may use them. Not all patients use or need all levels of care, yet all are available if they are needed.

Most people think of hospice as a place for someone who is terminally ill to go. Hospice is not a place, but a concept of care. Most hospice services provided in this country are based in the home. Care provided in the home allows families to be together when they need it most, sharing the final days in peace, comfort, and dignity. Sometimes home care is not an option and in-patient care can be available through a contracting hospital, skilled nursing facility, or the hospice’s own in-patient facility (if available). In addition, in-patient care is available to those receiving home care in emergency situations or when family members need respite care. Below are more myths about hospice:

• Myth: Hospice only serves people diagnosed with cancer
  Fact: Although 71% of the patients who were admitted to hospice agencies in 1996 had conditions related to cancer, there were other frequent admission diagnoses. Those include diseases of the circulatory system; infectious and parasitic diseases, which includes human immunodeficiency virus (HIV); diseases of the nervous system and sense organs, including Alzheimer’s, Parkinson’s, meningitis, etc.; and diseases of the respiratory system.
• Myth: A patient must have Medicare or Medicaid to afford hospice services
  Fact: Although insurance coverage for hospice is available through Medicare and in 44 states under Medicaid, most private insurance plans, HMOs, and other managed care organizations include hospice care as a benefit. In addition, through community contributions, memorial donations, and foundation gifts, many hospices are able to provide patients who lack sufficient payment with free services. Other programs charge patients in accordance with their ability to pay.
• Myth: A physician decides whether a patient should receive hospice care and which agency should provide that care 
  Fact: The role of the physician is to recommend care, whether hospice or traditional curative care. It is the patient’s right and decision to determine when hospice is appropriate and which program suits his or her needs. Before entering a hospice, however, a physician must certify that a patient has been diagnosed with a terminal illness and has a life expectancy of six months or less.
• Myth: Hospice services are very expensive because 24-hour on-call services are provided
  Fact: Generally, hospice costs less than care in hospitals, nursing homes, or other institutional settings for one basic reason: in those facilities a patient is charged each day for all general services such as food services and basic medical supplies. With hospice, a patient pays only for the services he or she or the family cannot provide and that are not covered by insurance. It is estimated that Medicare’s hospice program saves $1.68 for every dollar spent for Part A benefits in the last month of life.
• Myth: To be eligible for hospice care, a patient must already be bedridden?
  Fact: Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient’s physical condition. Many of the patients served through hospice continue to lead productive and rewarding lives. Together, the patient, family, and physician determine when hospice services should begin.
• Myth: After six months, patients are no longer eligible to receive hospice care through Medicare and other insurances
  Fact: According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, he or she can continue receiving hospice care as long as the physician recertifies that the patient is terminally ill. Medicare, Medicaid, and many other private and commercial insurances will continue to cover hospice services as long as the patient meets hospice criteria of having a terminal prognosis and is recertified with a limited life expectancy of six months or less.
• Myth: Once a patient elects hospice he or she can no longer receive care from the primary care physician
  Fact: hospice reinforces the patient-primary physician relationship by advocating either office or home visits, according to the physician preference. Hospices work closely with the primary physician and consider the continuation of the patient-physician relationship to be of the highest priority.
• Myth: Once a patient elects hospice care, he or she cannot return to traditional medical treatment
  Fact: Patients always have the right to reinstate traditional care at any time, for any reason. If a patient’s condition improves, he or she can be discharged from a hospice and return to aggressive, curative measures, if so desired. If a discharged patient wants to return to hospice care, Medicare, Medicaid, and most private insurance companies and HMOs will allow readmission.
• Myth: Hospice means giving up hope
  Fact: When faced with a terminal illness, many patients and family members tend to dwell on the imminent loss of life rather than on making the most of the life that remains. Hospice helps patients reclaim the spirit of life. It helps them understand that even though death can lead to sadness, anger, and pain, it can also lead to opportunities for reminiscence, laughter, reunion, and hope-hope that hospice will enable a patient to live his or her life to its fullest.

Often, patients and their families are referred to hospice by a physician or other medical professional (nursing home, hospital discharge planner, etc.). But in other cases, the patient and their family contacts the hospice directly to determine whether this service meets their current physical, emotional, and spiritual needs. If after learning more about hospice, you believe that you or your loved one may be eligible, here are the steps you can take to elect the hospice benefit:

• Call 580-303-7877
• A High Plains Hospice representative will explain the services offered, ask some health-related questions to begin the assessment eligibility, and answer any initial questions you may have.
• If the person lives within High Plains Hospice’s service area and appears to be eligible for hospice, an appointment will be scheduled for a member of our care team to visit for a more thorough eligibility review.
• If this in-person review continues to indicate eligibility, the hospice team member will answer any of your questions and walk you step-by-step through the process of electing the hospice benefit. Hospice will coordinate the hospice certification process with your physician, if necessary.
• A registered nurse will then visit the patient to conduct a physical assessment and begin to develop an individualized plan of care in conjunction with the patient, family, and the entire interdisciplinary care team. The nurse will also coordinate care with the patient’s attending physician, if applicable.

To learn more about High Plains Hospice and to see whether hospice is the right answer for you or a loved one, please call 580-303-7877.