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Myths / Truths About Hospice

MYTH:

Hospice is only for the wealthy.

TRUTH:

Everyone is entitled to hospice. Medicare, Medicaid, and most private insurers provide hospice benefits. At Family Hospice, no one is turned away due to inability to pay.

MYTH:

Hospice means giving up.

TRUTH:

Hospice is about making the most of life. A study published by the Journal of Pain and Symptom Management (March, 2007) showed that patients who choose hospice care live, on average, one month longer than those who do not receive hospice care.

MYTH:

A doctor's order is required for hospice to discuss their services or evaluate a patient's eligibility.

TRUTH:

Patients can choose for us to meet with them and/or assess them without an order. We cannot deliver care without an order. Medicare does require the physician to "order" the plan of care before it’s implemented. (Code of Federal Regulations (CFR 418.22)

MYTH:

To be eligible for the hospice Medicare benefit, the patient can only live up to six months.

TRUTH:

Life expectancy for the patient is six months or less if the illness runs its normal course. (CFR 418.22 3b)

MYTH:

The patient must have a DNR to be eligible for hospice.

TRUTH:

The law actually mandates that hospices NOT discriminate against beneficiaries because of any advance directive choices that they may or may not have. (Center for Medicare Services (CMS) Publication IOM Pub. 100-1, Ch. 5, Sect. 10.4)

MYTH:

To obtain hospice care, I must first stop receiving treatment that I am currently receiving.

TRUTH:

The hospice Medicare benefit does not mandate that the patient stop treatment. The benefit states that the treatment cannot cure. If the treatment will cure or prolong their life beyond 6 months, the patient is no longer eligible. (CFR 418.24 b2)

MYTH:

If the patient chooses hospice, they must give up their PCP and the hospice medical director will control their care.

TRUTH:

The patient chooses the physician that he/she desires to be the attending. The attending is the physician “identified by the individual as having the most significant role in the determination & delivery of care.” (CFR 418.3 b)

MYTH:

Under hospice care, the patient will receive only one level of care.

TRUTH:

There are 4 levels of care which hospices are required to provide when patients meet criteria for that level of care: Routine, Respite, General Inpatient and Continuous Care. (Internet Only Manual Pub. 100-2, Ch. 9, Sec. 40)
 

What do the levels of care terms mean?

Routine Home Care
If an enrolled hospice patient has manageable pain and symptoms upon admission, the patient is placed on the routine home care level of services. This level applies whether the patient resides in a facility or in a private residence.

Respite Care
Family members who have been providing round the clock care for a loved one may become exhausted and need a short break, or "respite", to recharge their energies. In respite care, the patient can be transferred to one of our two inpatient hospice centers for up to five days while the family rests at home or gets away for a change of routine. After the respite period, the patient is transferred back home.

Inpatient Care
If a patient's pain and/or symptoms require a more acute level of care than is recommended in the home, an aggressive inpatient approach to regaining the patient's comfort may be necessary. Short-term Inpatient care at one of Family Hospice's two Inpatient Centers allows staff to provide constant assessment and monitoring of efforts geared toward making the patient comfortable. 

Continuous Care
This is designed for patients whose symptoms cannot be controlled by the routine level of hospice care, In these cases, every attempt is made to control the patient's suffering at home with short-term continuous services that exceed the routine hours of care.