One of the most important decisions you will make for yourself, a loved one or your family is selecting a hospice provider. Every hospice program is required by law to provide the same basic services to patients and their families. So, how do you know you’re picking the best hospice program?
Keep these factors and questions in mind when selecting a hospice provider to ensure you and your family receive the professional, compassionate end-of-life care you deserve.
Examine the provider’s track record and reputation.
How long has the service provider been in operation? Does it provide care through its own employees or through contracts with other organizations? What do other patients/families have to say about this provider?
Examine the certification, licensing, and payment policies of the provider.
Is the hospice in your state Medicare-certified, licensed, and accredited? Is it recognized as a We Honor Veterans program by the Department of Veterans Affairs (VA)? For hospice care, does it accept Medicare, Medicaid, VA benefits, and most private insurance plans? Is it a charity that provides care to patients who have little or no medical insurance or financial resources?
Learn about the scope and depth of care you and your family will receive.
Is an individualized care plan created by the program? Is each patient assigned an interdisciplinary team from the hospice, including a nurse, physician, aide, social worker, chaplain, bereavement specialist, and volunteer? How often do team members visit? Do they teach family members and caregivers how to care for hospice patients at home?
Make certain that the program offers all four levels of mandatory hospice care.
Hospice care at home (wherever you call home, including a private home, nursing home, or assisted living facility); continuous care up to 24 hours per day (when medically necessary); inpatient hospice care (when symptoms and pain cannot be managed at home); and caregiver respite care (up to 5 days) Is the provider responsible for providing the patient with all medical equipment, medications, and supplies related to the terminal diagnosis at no cost?
Inquire about timing, emergencies, and the program’s ability to provide specialized care.
How soon can hospice care begin? Are patients admitted 24 hours a day, seven days a week, including weekends and holidays? Is there a 24-hour hotline staffed by trained hospice clinicians to answer your questions and respond in times of emergency or crisis? Will someone accompany you or a loved one when they die?
Examine the provider’s ability to care for seriously ill or complex patients.
Is it capable of caring for patients who require complex modalities or have more than one chronic disease? Are team members trained in specialized comfort care for cardiac patients, patients with lung disease, Alzheimer’s, and so on? Do team members provide care that respects specific populations’ cultures, traditions, beliefs, and needs (for example, veterans, LGBTQ, African Americans, Latinos, Haitians, Asians, Jews, and so on)? Does it offer palliative care to patients who are not yet hospice candidates?
Investigate available services for assistance.
Is it possible for families to be trained to use medical equipment at home? Is the program integrated with services such as music therapy, massage therapy, pet visits, and so on? What types of services do volunteers provide, and how are they trained? Are members of the team available to discuss advance directives and advance care planning? How long will bereavement services be available after a death?
When the word “hospice” is suggested for a loved one, family members often react with mixed emotions. Grief, anger, fear, hopelessness, and regret are all common initial reactions. What family members and caregivers should understand is that the doctor’s recommendation is motivated by compassion.
When continuing treatment is no longer the best option, hospice care takes over. Hospice focuses on care rather than cure. Hospice’s goal is to make the patient’s final days as comfortable as possible. That almost always means that a patient’s quality of life improves as soon as he or she enters hospice care.
In most cases, hospice care is provided in the patient’s home, allowing him or her to be in a familiar setting, surrounded by loved ones. Hospice care is also available in hospitals, nursing homes, and other long-term care facilities.
Where and how to begin your search for a hospice.
So, how do you locate a hospice provider? Starting with the healthcare professionals who supervise care is a good place to start. They have most likely referred many patients and have received a great deal of feedback from families — both positive and negative — that they can share with you.
As with anything else health-related, ask friends and family for hospice recommendations. It’s critical that you trust the source of your information, and your friends and family are unlikely to lead you astray.
When determining how to choose a hospice, one obvious place to look is online sources. When searching online, be sure to include your desired location. This can help you narrow down your choices. A search engine, such as Google, is the most obvious place to start, as are social media platforms (though when reading reviews, consider that everyone’s situation is different, especially when it comes to hospice, and one family’s experience may not reflect what you and your loved one may come to expect). Medicare’s Hospice Compare is a reliable resource for side-by-side comparisons. You can search for hospices by name or location, save agencies to a “favorites” list, and compare them.
Questions to Ask When Choosing a Hospice
Knowing what questions to ask about hospice care is just as important as knowing who to ask. According to the American Hospice Foundation, which was founded to improve access to quality hospice care, the following are some key questions to ask in your search for the hospice that is right for you:
- How long has the hospice been in business?
- Is the hospice Medicare certified, accredited, and state-licensed, if applicable?
- How does the hospice assess and track the quality of its services?
- Are any services provided in addition to the required services? Also, what kinds of bereavement services are available?
- What are the expectations for the role of the family in caregiving? Is there respite care available for exhausted family members?
- What is the typical number of hours spent with a patient? Is this more prevalent in the last few days or hours of a patient’s life?
You may also want to ask the following questions:
- Is it possible for the hospice staff to meet with you on the same day that a doctor’s recommendation is made? How long does the admissions procedure take?
- Is it possible to admit a patient at night, on weekends, or on holidays, or are admissions restricted to certain hours during the day?
- Is the agency entirely staffed by its own employees, or does it use agency personnel?
- Is there a dedicated on-call team available 24 hours a day, seven days a week?
- Will the hospice make every effort to have someone with the patient during his or her final moments (nurse, aid, chaplain, social worker, etc.)?
- What is the average number of weekly visits provided by the hospice?
Pay attention to your impressions after you’ve contacted a hospice program and interacted with staff members. Were the representatives with whom you spoke sympathetic? Were they effective communicators? Did they answer all of your questions satisfactorily?
Learning about end-of-life care options can help to turn a difficult situation into a “good death.” Gather information and ask the right questions to ensure you choose the best hospice provider for your family and your specific situation. Make certain that interactions, experiences, and memories are positive and heartwarming for years to come.
