When choosing a hospice, you should seek out
references from people you know and professionals in your community, and
also speak with hospice staff and family members and patients using the
hospice services. You also need to consider and be aware of a number of
other things:
-
Acceptance Factors:
Hospices usually base eligibility policies upon life expectancy and
certain other conditions. Many require that a designated primary
caregiver be available for home hospice care.
-
Inpatient Care:
Hospices have varying arrangements for providing inpatient care. Some
hospices own inpatient facilities, while others lease beds from
hospitals or skilled nursing facilities and provide staffing or care
plan supervision. Hospices also have different policies regarding the
requirements for an inpatient admission and the length of stay.
-
Special Services:
Some
hospices provide access to medical rehabilitation therapists,
dietitians, psychologists, or family counselors. They may also provide
music therapy and special day programs, among other special services.
Some hospices can arrange for medical equipment and supplies to be
delivered to the home.
-
Care
Plan:
The
hospice agency should work with each new patient and their family
members to develop a care plan. The care plan lists the specific
services required, the name and telephone number of the professional in
charge of administering the services, and the days and times when the
services will be delivered. The care plan should be revised as the needs
of the patient change.
-
Accreditation:
Hospices that are accredited by the Joint Commission on Accreditation of
Healthcare Organizations (JCOAHO) must pass inspections and meet higher
standards of care than those hospices that are not JCOAHO accredited.
The JCOAHO is an independent, nonprofit organization that evaluates and
accredits health care organizations.
-
Certification and Licensure:
Hospice agencies that are Medicare certified have met federal minimum
requirements for patient care and management and will be covered by
Medicare. Medicare-certified hospice programs are required to provide
certain services, including home health care, inpatient respite care,
medical social services, physical therapy, and 24-hour access to
professional care. Most states also license hospice programs.
Questions to Ask When Choosing a
Hospice Program
Hospice care is a philosophy of care that accepts dying
as a natural part of life. When death is inevitable, hospice seeks neither to
hasten nor postpone it. Below is a list of questions you should consider when
looking for a hospice program.
- What services are provided?
- What kind of support is available to the
family/caregiver?
- What roles do the attending physician and hospice
play?
- What does the hospice volunteer do?
- How does hospice work to keep the patient
comfortable?
- How are services provided after hours?
- How and where does hospice provide short-term
inpatient care?
- Can hospice be brought into a nursing home or
long-term care facility?
How do I ensure that quality
hospice care is provided?
Many hospices use tools to evaluate how well they are
doing in relation to quality hospice standards. In addition, most programs
conduct family satisfaction surveys to get feedback on the performance of their
programs. To assist hospice programs in these efforts, the National Hospice and
Palliative Care Organization has developed recommended standards entitled
'Standards of Practice for Hospice Programs as one means of self- and
field-evaluation.
Hospice services are often underused because
doctors and families are reluctant to acknowledge that the patient has less
than six months to live. However, staying open to the option of hospice can
ease the burden of death for patients and their families. Hospice can also
offer a very humane alternative to the sterility and denial of hospital
end-of-life care.
