When is Hospice Care the Right Choice and How to Select the Right Facility

Hospice Care can be obtained through a home health agency, a hospital or a skilled nursing facility. U.S. Congressional reports indicate that, in 2003, 56 percent of the hospice agencies were operated by non-profit organizations, 36 percent by for-profit organizations, eight percent by the government and one percent by other sources.

Hospice originally centered on cancer patients and, although 60 percent of all hospice patients between 1998 and 2002 had cancer, Medicare has recently reported a substantial growth in hospice patients with non-cancer diagnoses.

In What Setting Is Hospice Care Typically Provided?

Hospice Care is available in three settings: 1) private homes; 2) Hospice inpatient facilities; and 3) acute care hospitals.  According to the National Hospice and Palliative Care Organization (NHPCO), 66.7 percent of all Hospice patients are treated in the place they call home.

The private home category includes private residences (either one’s own or that of a relative), nursing homes, and residential facilities.  Another 21.9 percent are cared for in freestanding hospice inpatient facilities and 11.4 percent in acute care hospitals.

The number of freestanding hospice facilities is growing rapidly, partly due to the large number of families with two working spouses who cannot stay home to care for a dying parent. Other families have neither the space to accommodate the patient nor the physical or emotional strength needed to be a caretaker, a reality that is often true of an elderly spouse.

Freestanding hospice facilities strive to make the environment as homelike as possible. As such, they often include family suites with private rooms/baths, comfortable homey decor, kitchenettes for family use, garden spaces, chapel, community rooms, laundry facilities, and family dining rooms.

The Questions That Will Help You Choose the Right Facility

When choosing a facility, it’s wise to speak with the patient’s doctor and/or a medical social worker and get their recommendations. Also, speak with representatives of hospice programs being considered and, if possible, get references from families that have had experience with the program. The following questions will help you get the information you need to make the best decision.

  • How long has the hospice been in business?
  • Is it certified by Medicare? Accredited for having met national standards for patient care/safety? (Note: states differ in relation to certification and accreditation.)
  • How and by whom will the patient’s care plan be decided upon?
  • Is there a strategy in place in the event of a power failure or natural disaster?
  • How are home care aides trained and supervised?
  • Does a professional teach the patient and caretaker how to use equipment like a suction machine, oxygen or a wheel chair?
  • How does the hospice assure the confidentiality of patient records?
  • Is there a 24-hour number to call in the event of an emergency?

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