UNDERSTANDING HOSPICE

Hospice care focuses on your quality of life near the end of life's journey. The main goal, as a hospice team, is to surround you and your family with comfort and support. The team works together to provide you with superior pain and symptom management so that you're comfortable and able to focus on the people and the things that matter most to you.

Typically, family members serve as the primary caregivers and help make decisions for their loved ones in hospice care. An Advance Directive is very helpful during this time, as it's a document that clearly outlines a patient's wishes regarding medical treatment. If you need help preparing an Advance Directive, check out these two resources: here's one for DC residents & here's one for Maryland residents.

Hospice care is generally provided in your home, your family member’s home, or in a nursing home if that’s where you live—wherever you call home, our team is able to come and care for you there. We serve residents of the District of Columbia, and of Montgomery and Prince George’s Counties in Maryland.

 

How can hospice help me?

When you’re facing a serious illness and a cure is no longer effective (or isn’t adding to the quality of your life), you have the right to an end-of-life journey on your terms. Hospice comes to wherever you call home to give you comfort care and the support you need and deserve.

What does comfort care mean?

Comfort care means:

  • attention is on keeping you comfortable and managing your pain and symptoms when you’re no longer receiving curative treatment for your illness

  • you can stay at home with the people and things you love and a hospice team will come and care for you wherever you are: house, apartment, assisted living facility, group home, or nursing home

  • you’re in charge of your own care along with a team of hospice professionals who address your physical, emotional, spiritual, social, and financial pain

  • you don’t give up your primary doctor – if you wish, your doctor along with our hospice doctor and a registered nurse work as a team to give you medical care that manages your pain and symptoms

  • your caregiver, often a family member, is primarily responsible for your daily care (such as personal hygiene and giving medications) with teaching and guidance from our hospice staff

  • a certified nursing assistant helps you with personal care and other light duties

  • a chaplain talks and prays with you and your family, if you wish, and, when asked, works with your pastor

  • a social worker helps you access community resources so you remain independent and receive as much community support as possible for as long as possible

  • a grief counselor helps you and your loved ones deal with the emotions surrounding your serious illness

  • a trained volunteer stays with you when your caregiver has to run errands or keep appointments

  • the hospice team is available 24 hours a day, seven days a week to answer your questions and make home visits when needed

What does serious illness mean?

You have a serious illness when your doctor believes that, if your illness runs its natural course, you have a  life expectancy of six months or less. Hospice takes care of you as long as you qualify for hospice – there is usually no six-month time limit on your hospice services.

 

What specific services are provided?

A hospice team:

  • manages your pain and symptoms in your home (or assisted living facility, group home or nursing home) 

  • helps you with the emotional, psychological, financial, and spiritual aspects of dying

  • coaches your family on how to help take care of you

  • provides bereavement care and counseling to your family and friends

Can I afford this?

Typically, there's no cost to you. Both Medicare and Medicaid provide excellent hospice benefits including the cost of all medications and equipment related to the hospice diagnosis. Most private insurance programs offer hospice benefits as well. Hospice cares for everyone who qualifies for hospice regardless of your ability to pay for our services.

These hospice services are covered by Medicare, Medicaid, and most private insurance companies:

  • your medical care (a registered nurse visits you as often as needed and our physician is available for visits and consults)

  • they order, pay for, and deliver to your home all your medications related to your illness (and fill your pill box if you wish)

  • they order, pay for, and deliver to your home all your medical equipment (such as a hospital bed, wheelchair, commode and oxygen)

  • they order, pay for, and deliver to your home all your supplies (such as dressings, disposable pants and lotions)

  • they pay for your emotional and spiritual support (our chaplain talks with you in the privacy of your home)

  • they pay for your grief support (our bereavement counselor is available to meet with you individually and with your family members)

  • they provide you volunteer support (specially trained, dedicated adults support you and your caregiver)

The team will provide care for anyone who qualifies for hospice, regardless of your ability to pay for our services.

 

What if I need more care than I can get at home?

Hospice care provides you care in four different ways depending on your needs:

  • Routine Home Care – they come to your home or care facility and control your pain and symptoms with medications, medical equipment and visits from their Registered Nurses. Their staff visits you as often as they and your doctor determine you should be seen and you always have access to a hospice nurse 24/7.

  • Inpatient Care – if your pain and symptoms can’t be managed well in your home, they will work with their partners to get you into an inpatient facility that provides 24/7 on-site nurses and aides, working with a hospice doctor, and with a social worker and chaplain five days a week. The goal of inpatient hospice care is to get your pain and symptoms under control so that you can return home.

  • Continuous Nursing Care – they will come to your home when your pain and symptoms can’t be managed well there but you don’t want to leave. A Registered Nurse and an aide provide coordinated coverage for at least eight (8) hours daily for a brief period of time. This care is provided under most insurance plans.

  • Respite Care – they contract with a facility where you stay for up to five (5) days so that your caregiver can have some much-needed time to herself/himself and then you return to routine home care in your home.

How do I tell my family what kind of care I want? 

It’s important that those closest to you know how you want to live the final months and days of your life – telling them what’s most important to you takes the burden off of them to make those decisions for you. Sharing your end-of-life wishes is one of the best gifts you can give your loved ones. It means you’ll have quality of life through the end of your life with all decisions made according to what you want – not what your doctor or family member wants.

Here are some tools that might be helpful:

  • identify what’s most important to you and how you want to live your life

  • complete an Advance Directive form that gives your loved ones and healthcare providers instructions on what you want and don’t want and makes your wishes legally binding

  • start end-of-life conversations with your family

  • complete the Maryland MOLST Form if you’re a Maryland resident

  • complete a Healthcare Power of Attorney form

Do all hospices provide the same care? 

 

Most hospices are Medicare certified and must follow Medicare rules and regulations. There are hospice core services that must be provided directly by hospice employees on a routine basis (required by the Centers for Medicare & Medicaid Services - CMS). The core services that every hospice must provide are:

  • physician services

  • nursing services routinely available and/or on call on a 24-hour basis, 7 days a week provided by or under the supervision of a registered nurse (RN) functioning within a plan of care developed by the hospice in consultation with the patient’s attending physician, if the patient has one

  • medical social services by a qualified social worker under the direction of a physician

  • counseling (including but not limited to, bereavement, dietary, and spiritual) counseling

  • bereavement services for the family and other individuals identified in the bereavement plan of care for up to one year following the death of the patient.

Hospices historically were run by nonprofit organizations that operated independently. Today, most hospices are still run as independent nonprofits, but many for-profit hospices are also providing end-of-life care.

The differences between for-profit and non-profit hospices are:

  • their missions – every nonprofit organization has a purpose, known as its mission, and unlike a for-profit organization, a nonprofits mission is not to generate revenue but to fill societies unmet needs

  • their donations - nonprofits may use charitable donations from the community for direct patient care while for-profits may not

  • their tax status – for-profits must pay taxes on reimbursement money they receive from state and federal governments while nonprofits are exempt from paying taxes on donations, grants and federal government funding

 
 
 
 
 
 
 

ADDRESS

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Fax: 240-839-3391

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