Frequently asked questions
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What is "hospice" care?
Hospice (pronounced "HOS-pis") is a program of care that promotes quality of life during a life-limiting illness. Hospice recognizes dying as a normal process. Hospice care provides comfort when cure of the illness is no longer possible. Hospice neither prolongs life nor hastens death. Hospice caregivers offer patients and their families physical, emotional and spiritual care at the end of life.
- What is "palliative care"?
Palliative (pronounced "PAL-ee-uh-tihv") care focuses on improving quality of life for patients with life-limiting illness and their families by relieving symptoms, exploring treatment goals and choices and providing emotional and spiritual support.
- What does hospice care cost?
Most major insurance companies offer a hospice benefit. To be sure of coverage, families should check with their employer or health insurance provider. Medicare and Medicaid also provide coverage, as applicable to the individual case. If a patient does not have insurance or Medicare, the first thing Hosparus will do is determine their eligibility for coverage through government programs; however, Hosparus accepts all patients meeting admission criteria regardless of their ability to pay. We receive our income from Medicare, Medicaid, health insurance, individual payments, donations, fundraising and grants. We also bill patients for deductibles, co-pays and services not covered by insurance, such as delivery of medications. Patients with limited resources are billed according to their ability to pay. Many patients and families request that expressions of sympathy be made to their individual hospice. These contributions are acknowledged both to the donor and patient’s family and allow us to provide our services to all persons in our community.
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Does hospice cover the cost of medications?
Hospice only covers the cost of medications related to the hospice diagnosis. In conjunction with the Hospice Pharmacia, a pharmacy specializing in medications needed by hospice patients, we have a list of medications proven effective for relieving the symptoms experienced by people with life-limiting illnesses. Those medications are covered. However, sometimes patients take other medications that are not covered by the hospice benefit. The hospice team will work with the patient's doctor to get related medications changed to medications that are included in the hospice guidelines. - What is the role of the family and primary caregiver?
The family and primary caregiver continue to provide care and support to the patient. Hospice care is intended to supplement this care, not to replace it. Hospice team members are ready and willing to listen to concerns and offer assistance with caregiving plans. The team teaches the family and primary caregiver symptom management and supportive skills.
- Who decides when hospice care starts?
Hospice is an option that can be discussed when a life-limiting illness affects the patient and family. By law, the patient must choose hospice care. Hospice staff realize that the decision to stop curative care can be very difficult. Staff are available to discuss these concerns with the patient, family and physician. For more information, call the hospice in your area.
Hospice of Louisville: Serving Kentucky's Bullitt, Henry, Jefferson, Oldham, Shelby, Spencer and Trimble counties. Call (502) 456-6200 or toll-free at (800) 264-0521. Ask for the admissions department.
Hospice of Central Kentucky: Serving Kentucky's Hardin, LaRue, Grayson, Breckinridge, Meade, Marion, Washington, Taylor, Green and Adair counties. Call (270) 737-6300 or toll-free at (800) 686-9577. Ask for the admissions department.
Hospice of Southern Indiana: Serving Indiana's Clark, Crawford, Floyd, Harrison, Scott and Washington counties. Call (812) 945-4596 or toll-free at (800) 895-5633. Ask for the admissions department.
- Won't our physician tell us when hospice is appropriate?
The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends. It is important to let your physician know that you are interested in hospice care. Click here for information on the role of the patient's attending physician.
- What if our physician doesn't know about hospice?
Most physicians know about hospice. If your physician wants more information, it is available from Dr. Joe Rotella, chief medical officer, Hosparus, (502) 253-9236 or toll-free (800) 264-0521. Information also is available from the American Academy of Hospice and Palliative Medicine, National Hospice and Palliative Care Organization, Hospice Foundation of America, medical societies, or the National Hospice Hotline, (800) 658-8898. In addition, physicians and all others can also obtain information on hospice from the American Cancer Society and the Social Security Administration.
- Is the home the only place patients can receive hospice care?
No. Hospice patients may reside in nursing homes. Patients also receive short-term inpatient care if needed for symptom management. For more information, click on nursing home care and inpatient care.
- What happens at admission?
The hospice contacts the patient’s physician to make sure he or she agrees that hospice care is appropriate for the patient. (If the patient does not have a physician, contact the appropriate hospice and the medical staff will assist with questions.) The patient will also be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The consent form states that the patient understands that the care is palliative (care that relieves pain through symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how choosing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.
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If I elect hospice, will my physician or treatment change?
With hospice, you can continue to go to your regular doctor. If you are admitted to one of our inpatient hospital units and your doctor does not go there, one of the Hosparus medical directors will assume responsibility for your care during your hospital stay. After you are discharged, your doctor will again be in charge of your care. Your treatment will be continually evaluated while you are a hospice patient. You may continue to receive Procrit, hydration, transfusions, chemotherapy and radiation; however, depending on the goals and effectiveness of the treatment, it may not be covered by the hospice benefit. Alternate medical therapies and experimental drug therapies may also not be covered by the hospice benefit. -
How do I prepare my home for hospice care?
Your nurse makes arrangements so that items such as a hospital bed, bedside commode, wheelchair or oxygen can be delivered to you by an appropriate company. Supplies such as disposable pads, gloves and dressings can usually be delivered by the nurse. If you have problems with equipment or supplies, contact your nurse or the Hosparus office and we will make arrangements for repairs or replacements. - How many family members or friends are needed to care for a patient at home?
The amount of care needed depends on the patient's needs. One of the first things a hospice team will do is prepare an individualized care plan that will, among other things, address the amount of caregiving a patient needs, and determine who will provide this care. Hosparus staff visit regularly and are always accessible to answer questions and provide support.
- Does someone need to be with the patient at all times?
In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. As the patient becomes weaker and needs more assistance, Hosparus generally recommends someone be there continuously. While family and friends must be relied on to give most of the care, we do provide volunteers to assist with errands and to provide a break and time away for major caregivers. Hosparus social workers can also help the family locate other resources for caregiving.
- Isn't it difficult to care for someone who is very ill at home?
It’s never easy and can be quite demanding. Hosparus team members provide care to patients and families during regular business hours (Monday-Friday, 8:30 a.m. to 5 p.m.). After hours, patients and families can call the Hosparus office for assistance. When an emergency situation cannot be resolved on the telephone, a hospice professional will visit the patient.
- What specific care is provided in the home?
Hospice care is provided by a team of bereavement counselors, certified nursing assistants, chaplains, doctors, nurses, social workers, volunteers and other therapists (expressive therapy or music therapy). Each is available to provide assistance based on his or her area of expertise, and the patient/family’s desire for help. In addition, Hosparus provides medications, supplies, equipment, hospital services and additional support in the home, as appropriate.
- How does Hosparus manage pain and discomfort?
Our hospice nurses and physicians are up-to-date on the latest medications and techniques for pain and symptom relief. Ongoing assessment and help for the patient and family are provided. Accurate, efficient follow-through with pharmacies assures that medications are available as needed. When pain is especially difficult, an admission to an inpatient unit can provide professional monitoring, pain control and medication management. Hosparus believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these as well through social workers, chaplains, expressive therapists and a music therapist. Additionally, music volunteers and resources, massage therapy, Comfort Touch, Healing Touch and other programs are available for relaxation and emotional support. Certified nursing assistants provide sensitive help with bathing, skin care and many practical needs of the patient.
- Is hospice successful in controlling pain?
Yes. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.
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What if we have a concern or complaint?
We are committed to providing you and your family with the very best quality of care, and we invite your comments about our services. Often we use surveys or interviews to get feedback, but you can call us at any time. If you have any problems, or have questions or suggestions, please talk with any team member or call the director of quality and compliance at (800) 264-0521. Our staff is trained to listen to your concerns with respect and appreciation for your willingness to help us improve; you do not need to worry about a negative response from us or about getting anyone "in trouble." -
What if we want to stop receiving hospice services?
It is your right and privilege to terminate hospice care at any time. Please discuss any changes you wish to make with one of your team members or call our office. We will consult with your doctor. - Is Hosparus associated with any religious organization?
No. Hospice care by Hosparus is not connected any religion. Our hospices serve the broad community and do not expect or impose any particular set of beliefs. Our hospice chaplains are sensitively skilled and trained to be of spiritual support for you, whatever your beliefs may be.
- What happens if the hospice patient's condition improves?
If the patient's condition improves and the disease seems to be in remission, Hosparus will discharge the patient, and he or she may receive other medical care. If a discharged patient should later need to return to hospice care, the patient can be readmitted to the program.
- Does Hosparus do anything to make death come sooner?
Hosparus does not prolong life or hasten death. The goal of hospice care is to relieve symptoms and keep the patient comfortable. Just as doctors and midwives lend support and expertise during the time of childbirth, Hosparus provides its presence and specialized knowledge during the dying process.
- Does Hosparus provide any help to the family after the patient dies?
Absolutely. Bereavement services are available to the family for 13 months after the death. Through the Bridges Counseling Center, skilled counselors offer support for both adult and children. Bridges Counseling Center offers a full range of bereavement services.
We hope these questions and answers have helped you better understand Hosparus care. For further help, call us at the hospice in your area.
