What is hospice care?
Considered the model for quality compassionate care for people facing a life-limiting illness, hospice provides expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Support is provided to the patient’s family as well.
Hospice focuses on caring, not curing. In most cases, care is provided in the patient’s home but may also be provided in freestanding hospice facilities, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients with any terminal illness or of any age, religion, or race.
What services are provided?
The interdisciplinary hospice team:
• Manages the patient’s pain and other symptoms
• Assists the patient and family members with the emotional, psychosocial, and spiritual aspects of dying
• Provides medications and medical equipment
• Instructs the family on how to care for the patient
• Provides grief support and counseling
• Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time
• Delivers special services like speech and physical therapy when needed
• Provides grief support and counseling to surviving family and friends
Location of Care
Most hospice care is provided in the place the patient calls home. In addition to private residences, this includes nursing homes and residential facilities. Hospice care may also be provided in freestanding hospice facilities and hospitals.
Levels of Hospice Care
Hospice patients may require differing intensities of care during the course of their disease. While hospice patients may be admitted at any level of care, changes in their status may require a change in their level of care.
The Medicare Hospice Benefit affords patients four levels of care to meet their clinical needs: Routine Home Care, General Inpatient Care, Continuous Home Care, and Inpatient Respite Care. Payment for each covers all aspects of the patient’s care related to the terminal illness, including all services delivered by the interdisciplinary team, medications, medical equipment and supplies.
Routine Hospice Care (RHC) is the most common level of hospice care. With this type of care, an individual has elected to receive hospice care at their residence.
General Inpatient Care (GIP) is provided for pain control or other acute symptom management that cannot feasibly be provided in any other setting. GIP begins when other efforts to manage symptoms are not sufficient. GIP can be provided in a Medicare certified hospital, hospice inpatient facility, or nursing facility that has a registered nurse available 24 hours a day to provide direct patient care.
Continuous Home Care (CHC) is care provided for between 8 and 24 hours a day to manage pain and other acute medical symptoms. CHC services must be predominately nursing care, supplemented with caregiver and hospice aide services and are intended to maintain the terminally ill patient at home during a pain or symptom crisis.
Inpatient Respite Care (IRC) is available to provide temporary relief to the patient’s primary caregiver. Respite care can be provided in a hospital, hospice facility, or a long-term care facility that has sufficient 24-hour nursing personnel present.