Though there are a few hospice houses in Southern California, most hospice care is provided in the patient’s home. If a patient lives in a skilled nursing facility, assisted living facility, or board and care facility, hospice care can be provided in those environments as well in coordination with the facility’s staff.
The hospice team will honor the patient’s and family’s wishes with respect to the use of pain medications. Admittedly, there is a trade-off between pain tolerance and alertness, but those decisions are directed by the patient and the family.
Hospice seeks neither to lengthen life nor to hasten death. Our approach is to allow nature to take its course, and to bring comfort, support, and peace to the patient and the family. Interestingly, many studies have shown that patients on hospice may actually live longer because their symptoms are being appropriately managed.
Hospice care is covered by Medicare, Medi-Cal, and most commercial insurance plans. For those patients who have Medicare or Medi-Cal, there are no out-of-pocket costs for hospice care.
For patients with commercial insurance, deductibles and co-pays vary based on the policy and the healthcare expenditures made year-to-date by the patient.
The length of stay for patients can vary widely depending on when a patient is referred to hospice with respect to their disease process. There are patients who come under our care who live a few weeks, and there are those who live a couple of years.
Patients and families can absolutely reach out to us directly to discuss their needs. We can set up a family meeting to provide information about hospice care, answer any questions they may have, and discuss care options.
If necessary, we can reach out to the physicians involved in the patient’s care and discuss hospice care with them as well.
For patients with Medicare or Medi-Cal, there is no limit to the amount of hospice care they can receive, as long as they meet hospice eligibility criteria.
For patients with commercial insurance, authorization is periodically required from the insurance carrier to continue care over extended periods of time.
Hospice care is an appropriate option when the burdens of curative care begin to outweigh the potential benefits. Determining that time is a personal matter for the family, in consultation with their primary care physician and specialist physicians.
When the patient and family have concluded that curative care is no longer appropriate, hospice care offers compassionate care and support that comes to the patient, with the goal of maximizing quality of life and facilitating a peaceful and meaningful life closure.
Curative care and hospice care thus serve different purposes at different stages of the disease process.
The truth is actually quite the opposite. In hospice care, the patient’s and family’s wishes, goals, beliefs, and values are very important to us, and we work hard to ensure that the patient and family are involved in determining a plan of care with which they are comfortable.
Hospice patients are not required to have a Do-Not-Resuscitate (DNR) or any other advanced directives.
The truth is that patients and families have the right to discontinue hospice care at any time for any reason. If they wish to come back to hospice care at a later date, they may do so as long as the patient meets hospice eligibility requirements.