Hospice

What is hospice?

Hospice is a higher level of palliative care with a holistic focus on treating patients with a terminal illness, wherever they call home. A hospice plan of care also embraces the family/caregiving unit by providing psychosocial support and bereavement support for up to 13 months after a patient passes.

Hospice is relatively young.

The modern hospice movement was founded in London, England by aspiring nurse-turned social worker-turned physician, Dame Cicely Saunders, who recognized that patients were abandoned by their families and physicians at end of life. She founded the first inpatient hospice, St. Christopher House, in 1967. The first US hospice, Connecticut Hospice, was founded Florence Wald, Dean of Yale School of Nursing, in 1974. Since the adoption of the Hospice Medicare Benefit in 1982, hospice has evolved into a comprehensive philosophy and mode of care with a focus on holistic, advanced symptom management and a goal of improving patient and family quality of life through end of life.

What services does hospice provide?

Hospice provides holistic, advanced symptom management to a patient with a terminal illness and support to his or her family/caregiving unit, when a patient has made the determination to stop aggressive, curative treatment.

Hospice provides all nursing care, prescriptions related to the hospice diagnosis, all medically necessary durable medical equipment, and all medical supplies.

After a patient passes, hospice provides bereavement services to our patient’s family for up to 13 months.

What’s the difference between palliative care and hospice care?

Palliative care is specialized care for patients living with serious, often chronic, but not necessarily palliative care is to improve quality of life for both the patient and family. Patients with multiple sclerosis, kidney disease, cancer, AIDS or patients dealing with the side effects of treatments for these diseases may benefit from palliative care.

A palliative care plan often includes nursing visits and social worker visits, but palliative care in general does not automatically cover prescriptions, medical equipment, or medical supplies.

Hospice is a higher level of care for patients with a terminal illness, who have made the decision to stop aggressive, curative treatment. Hospice care is palliative in nature, in that it is also focused on advanced symptom relief, including pain, nausea, anxiety, and shortness of breath, with the goal of improving quality of life for both the patient and family through end of life. A hospice plan of care also embraces the family/caregiving unit by providing psychosocial support and bereavement support for up to 13 months after a patient passes.

Hospice is a higher level of care in that they receive a larger care team comprised of at the hospice medical director or their attending physician, a registered nurse case manager and potentially LVNs that see them between RN visits, a certified nurse aide to assist with activities of daily living, a social worker, and a spiritual care coordinator. A patient and their family may also opt to take advantage of volunteer support services. 

What are the different levels of care in hospice?

There are four levels of care in hospice: routine, crisis or continuous care, general inpatient, and respite care.

Routine

Hospice care is meant to be provided at home. Hospice is not a place you go. It’s a service that’s provided to keep a patient out of the hospital/rehab and home where they are most familiar and comfortable.

98% of hospice care can be provided at home, wherever a patient calls home – private residence, assisted living/memory care, skilled nursing, etc. We’ve also provided care for patients experiencing homelessness.

Hospice is available 24/7. Should a patient experience a symptom overnight or need assistance, a nurse will triage by phone and give instructions. If that doesn’t alleviate symptoms within 20 minutes, the nurse goes out at any hour to assess, educate and treat.

Crisis or Continuous Care

In the event a symptom cannot be managed within the plan of care – sudden onset of extreme pain, for example – a registered nurse will come to the patient’s bedside and assess and treat until it’s managed for up to 8 hours. After 8 hours, an RN or LVN comes to do the same until the symptom is under control.

A change to this level of care is accomplished through a nursing order and is signed by a doctor.

This is not intended to be “sitting vigil.”

General Inpatient (GIP)

In the event a symptom cannot be managed at home, acute care is provided at the GIP level of care. It means that a patient receives inpatient care either at a hospital or inpatient hospice until. This is meant to be a quick hospital visit to get symptom under control.

Hospice continues to pay for the treatment and hospital stay.

Hospice will pay for transportation to the hospital/back home under GIP care.

A patient is not discharged from hospice for this level of care.

A change to this level of care is accomplished through a nursing order and is signed by a doctor.

Respite

Respite is intended to be a respite for a caregiver experiencing compassion fatigue or caregiver burn out.

Respite is possible with clinical eligibility under other circumstances as well, such as if the patient is not safe to stay wherever they were admitted to hospice.

Under respite care, a patient can be admitted to a contracted skilled nursing facility for up to five days. Hospice respite is provided only in a contracted skilled nursing facility.

Hospice will continue to pay for nursing care, but will also pay for the room and board at the SNF. Hospice will also pay for the transportation to/from the SNF under respite. A patient is not discharged for this level of care.

Medicare does not limit the number of times a patient can be at respite per episode.

A change to this level of care is accomplished through a nursing order and is signed by a doctor.

Who is eligible for hospice care?

A patient with a terminal illness who has made the decision to stop aggressive, curative treatment is appropriate for hospice care. A clinical review and nursing evaluation will confirm eligibility. 

Who pays for hospice?

Medicare Part A covers hospice care it at 100% under the Hospice Medicare Benefit.

Electing hospice does not exclude a patient from receiving Part B benefits, so a patient can continue to see other doctors not related to their hospice diagnosis. (For example, if a patient is admitted to hospice with breast cancer, and she wants to continue to see her podiatrist to treat an ingrown toenail or her endocrinologist to manage her diabetes, she is able to do that.) Hospice is meant to add care, not take away other benefits.

When hospice is elected with Medicare Advantage plan (combination of Medicare and commercial insurance), usually the policy reverts to straight Medicare and covers at 100%.

Commercial policy coverage varies and is subject to in/out of network provider contract status.

Medicare states that a hospice provider can bill responsibly financial party for up to 5% of services. JOL Healthcare doesn’t do that.

JOL Healthcare verifies all benefits and advises of coverage before initiation of any service.

When is the right time for hospice?

The feedback we hear most often from families is, “I wish we had done hospice sooner.”

Hospice does not prolong life or hasten death, but the sooner a hospice care plan is ablet to get symptoms managed, the better quality of life a patient has, for longer.

The resistance to hospice we hear most often is, “I don’t want to give up.” Hospice isn’t giving up. We want to spend our days, however numbered, on our terms, in our homes, with the people we love. Electing hospice is an empowered, dignified, loving way to accomplish that.

Where do I go for hospice care?

Hospice care is meant to be provided at home. Hospice is not a place you go. It’s a service that’s intended to keep a patient out of the hospital/rehab and home where they are most familiar and comfortable.

98% of hospice care can be provided at home, wherever a patient calls home – private residence, assisted living/memory care, skilled nursing, etc. We’ve also provided care for patients experiencing homelessness.

Hospice is available 24/7. Should a patient experience a symptom overnight or need assistance, a nurse will triage by phone and give instructions. If that doesn’t alleviate symptoms within 20 minutes, the nurse goes out at any hour to assess, educate and treat.

Why choose JOL Healthcare as your hospice care partner?

In central Texas, you have A LOT of options for a hospice partner.

If you are a patient or a family, choosing a hospice provider is one of the most intimate, vulnerable decisions you’ll make, and we have the utmost respect for that choice. You can trust JOL Healthcare to partner with you, every step of the way.

If you are a referral partner, you want a hospice provider that understands your needs and can meet those needs consistently and efficiently.

JOL Healthcare delivers.

As a company, what sets JOL Healthcare apart and above the rest is our clarity of mission, our “why,” and “how” we deliver on it.

Our Five Core Values: Passion, Professionalism, Integrity, Compassion, and Collaboration are what guide us on our mission to positively impact 1,000,000 lives through home health and hospice.

We work seamlessly as a Cohesive Team, offering the very best in Comprehensive Care, and providing Concierge Communication.

We’re educators, healers & comforters, practice builders, and community ambassadors.  

We strive to recruit and retain the very best professionals in the industry. We continue to educate our clinicians and staff and support work-life integration, because we know that cared for people provide better care.

What next? How do I move forward with hospice care?

Call us at 512-786-4198.

We’ll either answer your questions and address your concerns on the phone or set a time that’s convenient for you and your family to meet in person. Then, we’ll request some clinical information and schedule a time for a nursing evaluation and admission.

The process is simple, but we want to make sure you have all the information to make the best choice for yourself and your family.