By Marlo Sollitto
Hospice care is end-of-life care provided by health professionals who give medical, psychological and spiritual support. The goal of the care is to help people who are dying have peace, comfort and dignity. Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.
Hospices are independent organizations, which can be non-profit, for-profit or government-run. You likely have more than one Hospice in your area. When deciding on the program that is right for you, use this checklist to help you evaluate a local hospice service to make both you and your loved one more comfortable.
Here are some questions to ask about Hospice:
- Who owns the hospice service?
- Does the owner run the hospice? If not, who does?
- How long has the manager been running the hospice service or others like it?
- Is the hospice service nonprofit, for-profit or government-operated?
- Can I see the most recent financial report? (This will help you see how your money will be spent. Look at areas like staff wages, food costs, home and room improvements, activity budgets, etc.)
- Who is the best contact for additional, day-to-day questions?
State and Medicare Certification
- What accreditations, certifications, or licensures does the program have? (The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is a not-for-profit organization that provides accreditation for health care organizations and programs.)
- What were the results of your last state certification review? (What problems were uncovered? Have the problems been resolved? Or is there a plan in place to resolve them?)
- Is the hospice Medicare certified? (In order to be Medicare-certified, the hospice must meet certain federal requirements set by the Centers for Medicare & Medicaid Systems.)
- How many staff members are assigned to each patient? Per day? Per shift?
- How does that compare with other facilities in the area?
- What qualifications do you require of staff members? RNs? Aides? Volunteers?
- Is there a full-time social worker?
- Is there full-time therapy staff?
Services and Policies
- What services are offered?
- What services are included in the basic daily rate?
- What services are not covered in the basic daily rate?
- How many patients do you care for?
- How do you include patients in decisions regarding their care?
- How do you include family members/caregivers in decisions regarding patient care? How are they notified?
- Can family members/caregivers help the patient with personal care?
- What services will family members/caregivers be responsible for?
- What resources are available if a family member chooses to care for the patient at home?
- If the family or patient decides that home care isn't the best option, can the hospice plan be re-evaluated? Can additional help be provided?
- Will there be a written statement or contract outlining the terms of care? Is this negotiable? How often is this plan of care reviewed and revised?
- What policies/processes do you have for resolving issues?
- What other services might the hospice assist with if needed (dressing, bathing, meals, grooming, going to the bathroom, transportation, etc.)?
- If the hospice patient requires high-technology therapies or devices to manage pain and other symptoms, will this be an issue?
- What are the available support services for family members/caregivers?
- Does the organization provide home visits?
- Are there geographical boundaries or other limits to the home care services?
- Can hospice care be brought to a nursing home or hospital?
- How often do aides, volunteers, physicians, and other hospice team workers visit during the day? During the week?
- What kind of services are available over the weekend?
- Do other health care providers visit the home regularly? (Examples may include dentist, podiatrist for feet, physical therapist, occupational therapist, and physiotherapist.)
- Can the patient request additional visits when needed?
- How long does a visit with a health care provider typically last? How many night staff members are on duty or on call?
- What hospital or facility is used if inpatient hospice care is needed? Is that in a network with the insurance company or Medicare/Medicaid?
Costs and Insurance
- What is the price breakdown list of average costs?
- Does the hospice have a contract with the patient's insurance company?
- Is it Medicare certified?
- Does the hospice take Medicaid payments?
- Are there extra medical or health care charges?
- What out-of-pocket expenses might there be?
- Are there any grants, endowments, etc. that might help pay for hospice services?
- How soon can hospice services begin?
- What paperwork or forms are needed in order to initiate hospice care?
- Is an advanced directive required?
- If the patient would like to terminate hospice care, what is needed to end care?
Language, Culture, Religion
- Does anyone on staff speak the patient's preferred language?
- Are interpreter services available for language or for a patient who is hearing impaired?
- Do staff members know about the patient's culture? Do they understand that it may affect the type of care and how it is provided?
- Are members of faith organizations available to visit? How regularly?