Rochester, New York City Guide
Rochester, NY City Guide

© 1996-2015 Max Lent Communications




Hospice frequently asked questions (FAQ)

By Geoff Lister

Who is eligible for Hospice?

In most cases someone is eligible for Hospice if their doctor feels they have less than 6 months to live and also if they no longer want aggressive treatment for their illness. The person does not need to know their prognosis, but does need to no longer want to go back to the hospital for acute treatment. They need to have decided that if they have cancer they no longer want chemotherapy or extensive radiation. They need to know that once they are on Hospice, they will not be having IV medications or the inserting of a feeding tube. Someone who already has a feeding tube in place can be accepted on Hospice. While a person does not need to be “Do Not Resuscitate,” they need to know that if resuscitation leads to a hospital stay, they will be financially responsible for it. If someone has a non-cancer diagnosis, Medicare has specific criteria for admitting people with the most common illnesses. Usually blood work will need to be drawn to finalize eligibility for people who do not have cancer.

How is Hospice arranged?

The ill person, a family member or friend, or the physician can call one of the two Hospice providers in Monroe County: Hospice of Rochester—214-1400, or the Visiting Nurse Service Hospice—787-8315. The Hospice organization will send out an evaluator who will explain the services available under Hospice and will start the process of finding out if the person is eligible for Hospice. If the referral did not come from the physician, the Hospice will contact the physician to get his or her approval as well as some medical history. The actual admission decision is made by a team including the Hospice Medical Director, a social worker, and the evaluator.


What services are provided by Hospice?

A Hospice trained nurse will visit frequently to evaluate the person’s condition, teach family or friends how to better care for the person, and serve as a skilled set of eyes and ears for the physician. An on-call system provides 24 hour access to nurses who can either answer questions or visit. A social worker will visit to assist the person and their caregivers in dealing with stress, feelings, and the need for community resources. An aide can come to provide necessary hands on care. Volunteers can do anything that a family member can do such as provide respite or run errands. A non-denominational chaplain can visit to provide spiritual support. Bereavement follow-up is available in a variety of ways. Some medical equipment, such as hospital beds, oxygen, and commodes is covered, as well as some medical supplies related to the illness. Drugs related to the person’s comfort are covered at the pharmacy chain used by the Hospice.

Is Hospice covered by my insurance?

Medicare covers hospice fully without deductibles or copays. The Medicare benefit is administered as a managed Medicare. When someone signs onto Hospice they are signing off regular Medicare or their own managed Medicare, and onto “Hospice Medicare.” Their prior insurance remains available for care for a diagnosis clearly not related to the diagnosis for which they were admitted to Hospice. Under Medicare,
the Hospice Benefit is divided into benefit periods. The first two are each ninety days long and an unlimited number of 60 day periods can be added on. As long as the Hospice Medical Director determines that the person is eligible for Hospice, the care will progress from one period to the next. If the Medical Director feels the person is clearly improving rather than declining, they will contact the person’s physician and also may request that laboratory work be done.
Medicaid and many types of insurance cover Hospice fully and do not use benefit periods. Some insurances have copays or limits either of time or of coverage. The staff of the Hospice will contact the insurance if coverage is not clearly known.

What is the approach of the care provided under Hospice?

The philosophy of Hospice care is to do everything possible to control pain and symptoms without using aggressive measures such as IV’s, inserting feeding tubes, using ventilators, or doing cardiopulmonary resuscitation. The same approach is used whether the person is at home, in a “Comfort Care Home” or in an inpatient Hospice setting. Comfort Care Homes are independent places where two people at a time can receive 24 hour care without cost. The homes ask that the person’s physician be willing to certify that the life expectancy is less than three months. Nurses and trained volunteers care for the person; family are welcome to assist in the care and can visit at any time. Inpatient care is available for 10 to 14 days either for acute symptom control for problems like out of control pain, uncontrolled vomiting, or agitated confusion. This care can also be used for end of life care.

Can a person change their mind and come off Hospice?

A person can choose to revoke their hospice benefit and receive aggressive care. A Hospice nurse or social worker will come out to have a revocation form signed. This does take time. All Hospices ask the family or friends of the hospice patient to call them before taking the person to an emergency room. If the person clearly has an injury or illness not related to the hospice diagnosis, they can go to the emergency room or to the hospital for care, but please call Hospice to let them know where the person is going.

© 2001 Geoff Lister>. This document may be copied in its entirety freely. It may be reproduced in electronic and paper form under the condition that no charge be made for its reproduction and that the author is cited.  Please provide feedback to Geoff Lister



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