Hospice

For those in hospice care, improving quality of life is an important goal. Much like music therapy, art therapy can bring joy to hospice patients and improve their mental and physical health.

While art has been used as a form of therapy and grief care in cultures around the world for hundreds of years, the term “art therapy” wasn’t used until the 1940s. In the decades since, art therapy has taken on new forms and been used in new ways, with formal training and licensing regulations now in place.

When used for those in hospice, art therapy can provide substantial benefits for patients and caregivers. Let’s take a closer look at art therapy in hospice care!

What is Art Therapy?

Art therapy uses the creative process to help alleviate pain and improve patients’ mental health. For those in hospice, it can improve quality of life, reduce some symptoms, and provide a way for patients to express their emotions.

Art therapy programs come in many different forms and can be tailored to a patient’s specific needs. Typically, art therapy involves drawing, painting, creating collages, or another artistic endeavor. An art therapist will often offer group or one-on-one sessions.

Benefits for Patients

The benefits of art therapy have been observed in many different studies, and researchers have seen physical, mental, and emotional benefits for patients. From reducing patient pain to helping patients come to terms with their diagnoses, here are a few of the main benefits:

1. Reduce Pain

Many patients who have participated in art therapy have reported decreased pain. This can be because art provides a distraction from the pain a patient feels. Creating art also releases endorphins, which can help block pain. Plus, the creation process involves movement, which encourages patients to actively engage with their art and the environment.

2. Increase Quality of Life

One of hospice care’s main goals is improving a patient’s quality of life, and art therapy does just that! Patients who participate in art therapy have said that they feel calm, entertained, and motivated throughout the process. Art therapy can also give patients a sense of empowerment and increase their self-worth, which improves their quality of life.

3. Express Emotions

When coming to terms with a terminal diagnosis, hospice patients may struggle to put their emotions into words. Art provides a creative outlet for patients to express their pain, confusion, and inner conflict, allowing them to communicate without words. This act of self-expression, especially with the guidance of a licensed art therapist, can help patients better understand the emotions they’re trying to process.

4. Improve Mental Health

Many patients in hospice struggle with mental health issues like anxiety and depression. Because art therapy causes endorphins to be released and encourages self-expression, it can also improve patients’ mental health. By strengthening positive feelings, alleviating distress, and helping patients relax, it can even help reduce anxiety and depression.

5. Process Questions About Life

One of the hardest parts of receiving a terminal diagnosis is processing and accepting it. Many patients find themselves reviewing their lives, wondering if they left behind a meaningful legacy, or facing their fear of death. Art therapy can help patients face their questions about life and examine their feelings about life and death. Plus, the creative process gives the patient a piece of art that helps them leave a legacy for their loved ones.

6. Find Support

Many hospice patients struggle with loneliness and isolation. Receiving a terminal diagnosis can shift relationships and leave a patient feeling alone. Art therapy provides patients with the support of a licensed art therapist, who can help them process what they’re going through. Plus, group sessions can help a patient build community and receive support from others in similar situations.

Benefits For Caregivers

While most hospice art therapy programs are mainly for hospice patients, families and caregivers have also seen benefits. Seeing their loved one involved in art therapy can give them good memories of their loved one to hold onto.

If a caregiver can participate, art therapy can be a great source of self-care, helping them cope with their own feelings of grief. Plus, if caregivers participate alongside their loved ones in hospice, they may be able to process any conflicts and open up about their emotions together.

In addition, caregivers can receive social support from the art therapist and other caregivers involved in the art therapy process. They can ask questions about their complicated emotions and find community with others in similar situations.

Processing a terminal diagnosis and entering hospice care can be difficult for both patients and caregivers. However, art therapy can improve quality of life and allow patients and caregivers to receive the support they need. Plus, it can help participants express their emotions and wrestle with the deep questions they face. Whether in a group setting or one-on-one with a licensed therapist, art therapy can be an excellent option for those in hospice to explore

Hospice volunteers play a vital role in end-of-life care. From sitting with patients to assisting behind the scenes, volunteers give their time and energy to help those navigating the final chapters of their journey. While this task can be emotionally draining at times, volunteers can make an extraordinary impact on the lives of hospice staff, patients, and the patients’ families.

Keep reading to learn about what volunteering with hospice looks like and how you can get involved!

What a Hospice Volunteer Does

Most hospice volunteers serve hospice patients and their families by providing patient companionship and caregiver respite, allowing caregivers to have a break and attend to their own needs. Some volunteers provide transportation for patients or run errands on their behalf, while others sit with patients and talk to them, share their hobbies, and take care of their needs.

But there are also many other roles that volunteers can fill! Some hospice services need administrative help, like answering phones or filing paperwork. Other hospice volunteers help with community outreach and fundraising. Some people volunteer their professional services at a discounted rate or for free, like offering to help with landscaping, providing haircuts, or performing massage therapy.

If you have an interest that could benefit a hospice program, don’t hesitate to ask about it! You may be able to help in a way that your local hospice service hadn’t considered before.

Why Volunteers Are Important

Hospice workers have a big job, and there’s only so much they can do in a day! Volunteers help provide a deeper level of service for hospice patients. Plus, some patients don’t have family members who can visit them, and volunteers can help fill that gap and provide social support for patients. Interacting with volunteers can improve a patient’s quality of life.

Volunteers can also fill the critical job of providing respite for caregivers. Caring for someone who is terminally ill can be physically and emotionally exhausting, and volunteers can help caregivers have time to take care of their own needs and get a much-deserved break.

Even if volunteers don’t interact directly with patients and their families, their work is still important! Administrative volunteers help hospice services run smoothly, create a welcoming environment, and provide top-notch care and service for families.

Benefits for Hospice Volunteers

Volunteering with hospice doesn’t just benefit the patient and their caregivers; it also benefits the volunteer. Serving others is fulfilling work, as is the knowledge that you are positively impacting someone’s life. As volunteers build relationships with the patients and families they care for, they hear stories, meet new people, and create deep connections that help them better understand those in different situations from themselves.

Additionally, hospice volunteers who help those receiving end-of-life care often learn to appreciate life more. Everyone has a limited amount of time in their lives, and interacting with hospice patients can encourage volunteers to appreciate what they have and strive to live a more meaningful life with the time they’ve been given.

How Can You Get Involved?

Every hospice program has its own unique needs for volunteers. While some hospice services require volunteers to be over the age of 18, others allow high school students to volunteer. Start by contacting your local hospice program and asking about their requirements and needs. You can also use the National Hospice and Palliative Care Organization search to look for nearby hospice providers.

After you know more about your local hospice services, determine the amount of time you are willing to contribute and discuss your skillset with the program. They may suggest areas you can volunteer in or ways you can use your skills. After you’ve signed up and filled out all the necessary paperwork, they’ll typically provide training to help prepare you for situations you may encounter and to make sure you can care for patients well.

Becoming a hospice volunteer is more than just lending a helping hand; it’s an opportunity to impact the lives of those in end-of-life care. Giving your time and energy to those at the end of their journey can be a rewarding experience, and we hope that you’ll join the ranks of hospice volunteers who serve those in need with compassion.

If you or a loved one are receiving end-of-life care, you may be looking for ways to bring a little joy to each day. Hospice care is focused on managing the patient’s symptoms and improving their quality of life, including their mental and emotional health. In recent years, music therapy has grown in popularity. Research shows that music therapy can mentally, physically, and emotionally benefit hospice patients.

But what exactly is music therapy, and how can it help? Keep reading to find out!

What is Music Therapy?

While listening to music can be helpful for hospice patients, music therapy takes things a step further. Typically, a certified music therapist will assess the patient and determine how to use music intervention to help them in a specific area.

Depending on the patient’s needs, a music therapist may use live music or a customized playlist. Some music therapists combine relaxation techniques, like visualization or breathing techniques, with music. Sometimes, the patient will play music, sing, move to music, write songs, or analyze lyrics.

It’s important to note that music therapy may not benefit everyone. Some patients may have music-related triggers. A certified music therapist will consider each patient’s needs and preferences.

Music therapy may provide the following benefits to hospice patients:

Benefit #1: Helps manage pain

As surprising as it may seem, research shows that music can help with pain management. Because music acts as a distraction, it can provide short-term relief from pain. Additionally, music therapy can help with emotional pain and distress and improve patients’ mental health. If a patient is agitated, anxious, or depressed, music can create a calming atmosphere and help them relax.

Benefit #2: Encourages communication

Sometimes music helps us express emotions that we can’t put into words. As a patient copes with their terminal diagnosis, they may struggle to understand or communicate their feelings. Music can help them recognize their feelings – whether through lyrics that they relate to or through the emotions the music evokes. Plus, music provides an outlet to physically express those feelings by singing or moving to the beat.

Benefit #3: Boosts memory

For patients struggling with dementia, music may boost memory. Have you ever listened to a song and remembered something you did in the past while it was playing? Sometimes, we associate songs with strong memories, like our first prom or walking down the aisle at a wedding. Listening to familiar songs can help patients, even those with Alzheimer’s or dementia, access their long-term memory.

Benefit #4: Connects people

Many people who are in hospice struggle with feeling isolated and lonely. But music has a way of connecting us to others. Not only does the patient develop a beneficial relationship with the music therapist, but music can also increase empathy. This increase in empathy may help ease tense relationships with family members. On top of that, music also brings other social aspects into play. Music brings people together, whether the patient shares their favorite songs with loved ones or connects with another patient who likes the same musical genre.

Benefit #5: Improves quality of life

For many patients, music therapy can improve their quality of life by helping them relax and providing comfort. Favorite songs can create a familiar environment and help patients feel more at home. Additionally, music therapy can help patients remember the happy moments they’ve spent with loved ones.

While music therapy may not be the right fit for everyone, many potential benefits exist for those in hospice care. From managing pain to releasing tension, music therapy can help improve a patient’s quality of life and make the transition to end-of-life care a little easier.

For most families, hospice care takes place right inside the home. But your home isn’t a medical facility – how do you access the medical equipment and supplies needed to properly care for your terminally ill loved one?

Thankfully, Medicaid, Medicare, and most private insurance companies provide generous coverage for hospice care, including medical equipment and supplies. In most cases, the family won’t have to pay for any medical equipment or supplies out of pocket, but always confirm with your insurance provider so you don’t end up with unexpected expenses. Some insurance companies require that you acquire equipment from certain sellers.

Now, to give you a well-rounded understanding of hospice medical equipment and supplies, let’s review 6 frequently asked questions.

How do I know which medical equipment or supplies my loved one needs?

Short answer: Talk to your family member’s doctor. When you first request hospice care, both the primary care physician and the hospice medical director will assess your loved one’s overall health. If they certify that your loved one is eligible for hospice care, they will also determine what medical equipment and supplies are needed for your family member’s care.

Then, your hospice team of experts will work closely with you to coordinate the delivery and set-up of any equipment at your home. As your loved one’s condition changes, the equipment and supplies will change. For example, an oxygen tank may not be needed in the first month of hospice care, but it becomes necessary in the third month. Your loved one’s care is a continually evolving process, and your hospice team will help you navigate those changes.

What items qualify as “medical equipment”?

Medical equipment refers to items that are re-usable or intended for long-term use. Every hospice patient’s situation and care regimen are different, but some items commonly considered “medical equipment” are:

• Hospital bed
• Oxygen equipment
• Geriatric recliner
• Bedside commode or bedpan
• Nebulizer
• Shower chair
• Wheelchair
• CPAP machine
• Blood pressure monitor
• Walker or crutches
• Bed lift
• Feeding pump

This is not a comprehensive list, but it gives you a sense of which items are considered medical equipment. Your hospice team will continually assess your loved one’s condition and ensure that the right equipment is delivered when it becomes necessary.

What items qualify as “medical supplies”?

On the other hand, medical supplies are designed for one-time use. They are often easier to acquire and will be replaced as needed. Here’s an example list of medical supplies:

• Bandages and gauze
• Briefs, pads, and other continence care supplies
• Disposable gloves, needles, or syringes
• Oxygen tubing
• Personal care products, like soap and shampoo
• Cushions and wedges
• Catheters

You can certainly purchase any personal care items on your own, but hospice care will provide them, if you wish.

Will someone show me how to use the medical equipment and supplies?

Absolutely. A member of your hospice team will clearly explain how to use each piece of medical equipment. They will also educate you on the correct use of any medical supplies, as you may need to clean wounds or administer medications. If you have questions, your hospice provider will provide an emergency assistance number.

What happens when the medical equipment is no longer needed?

As your loved one’s condition evolves, medical equipment will come and go in your home. When something is no longer needed, your hospice team will arrange its removal.

Are there any extra supplies I should gather?

When you sign up for hospice care, the admissions nurse may suggest that you purchase a few supplies. While most things are provided through your insurance policy, there may be some items to purchase on your own. Confirm with your chosen hospice provider, but here are a few items you might choose to have on hand.

• Twin sheets (two sets)
• Disposable or cloth under-pads
• Baby monitor or bell for the patient to use when they need help
• Thermometer (forehead type is best)
• Bendable straws (if the patient does not have swallowing issues)
• Mild or bland food (like oatmeal, applesauce, pudding, or yogurt)
• Night lights for hallways and rooms
• Wastebasket near the bed
• Loose nightshirt or nightgown

You are not required to have any of these items on hand, but it may make the transition to hospice less stressful if you are prepared in advance. You can always double-check with the hospice provider to see if they will provide these items. In some cases, they will.

If you have more questions, reach out to a respected hospice provider in your area. They can answer any additional concerns you may have, regarding medical equipment or hospice care in general.

Choosing hospice care can be a difficult decision. Often, the conversation is hard and can bring a weight of reality to your situation. Even so, choosing end-of-life care may be the right and best next step for your family. Hospice care can actually lighten your load as a caregiver and make your remaining time as a family more enjoyable and comfortable.

If you’re wondering if it’s time for hospice care, here are 6 signs to consider. But first, let’s start with a basic understanding of the purpose of hospice care and how it can help your sick loved one as well as the rest of your family.

The Purpose of Hospice Care

While the phrase “hospice care” may seem a little scary, it’s important to remember the true mission and purpose of hospice care organizations. Hospice programs are designed to support and guide families. The experienced staff will care for your loved one during their final days and assist your family with caregiving needs. The goal of hospice is to allow a person to die comfortably and with dignity in their home or hospice centers, surrounded by those they love.

6 Signs That it’s Time for Hospice Care

Now, let’s talk about 6 signs that may signal it’s time to consider whether hospice might be the right option for your family.

1. Rapidly declining overall health

Perhaps the biggest sign that it’s time to consider hospice care is when there is a significant decline in health. Frequent trips to the hospital or reoccurring infections can quickly lead to a lower quality of life. Even less severe trends such as increased sleeping, mental confusion, and falls can be causes for concern.

Another clear sign that end-of-life care may be needed is if the individual is experiencing constant pain or shortness of breath. Hospice nurses are equipped to care for these types of health issues and can offer relief from pain or discomfort.

2. Given six months to live by a doctor

When a loved one receives a terminal diagnosis, end-of-life care is usually the next conversation to have. Hospice care organizations offer medical care, comfort, and support to families. If you have financial concerns, Medicare or Medicaid often cover many aspects of end-of-life care, provided the doctor determines that life expectancy is six months or less.

Even if you enroll in hospice care, it’s possible that the terminally ill person could make a full recovery or symptoms may lessen. If this occurs, great! You can always discontinue care or request to receive care for longer than the standard six months after talking with a doctor. If it seems likely that they won’t recover, though, end-of-life care could be the right option for maintaining the best quality of life.

3. Eating and drinking less

Have you ever had an older pet that stopped eating and drinking? Similarly, human beings also have a sense of when the body is letting go. Whether because of disease, diminished mental capacity, or simply old age, loved ones typically tend to eat and drink less when their time gets closer. They also tend to lose weight and experience changes in their body composition during this time. If you see this occurring, it may be time to consider asking hospice care to help.

4. Unable to perform daily tasks

When a loved one is unable to care for themselves, especially if they live alone, it may be time to consider hospice care. Everyday tasks such as eating, getting dressed, walking around, using the restroom, maintaining personal hygiene, and more become very difficult as health deteriorates.

Talk to a doctor to have your loved one’s health assessed, and with approval, you can look into your care options. A hospice care professional can make sure that your loved one has all the assistance needed, while maintaining their dignity and making everyone feel as comfortable as possible.

5. Displaying unusual or abnormal behavior

It can be emotionally distressing to see a loved one go through sickness and enter the final stage of life. Not only do you see the sudden physical changes, you also witness changes in their behavior and actions, such as changes in how they interact with friends and family.

Many loved ones who are in hospice care often make statements and requests that seem out of character. They might also begin to give away their personal belongings on a whim. Another sign to keep in mind is if your loved one is making apologies or saying goodbye. Ideally, a person will already be receiving hospice care by this point, but if not, it’s okay. There is certainly still time to request it.

6. Feeling stressed and overwhelmed as a senior caretaker

Being a caretaker is a serious commitment. While you may want to commit to caring for your loved one, which is admirable, it can be stressful to take on that responsibility and maintain the other parts of your life. Choosing hospice care for your loved one is not a selfish decision, but an act of love. It’s giving them the care they need and deserve, just as they loved and cared for you.

In some ways, deciding to enroll in end-of-life care may feel like you’re giving up or that you’ve stopped caring. That couldn’t be further from the truth. Enrolling in end-of-life care is about making your loved one’s life more comfortable. It’s about doing everything possible to ease their pain and make life better.

What’s Next?

If your loved one is exhibiting any of these signs (or many of them), the first step is to get them an appointment with a doctor. It could be that something else is wrong, and it’s better to catch it early. However, if the doctor does determine that the end of life is near, you can request hospice care assistance.

With the help of a trained end-of-life care professional by your side, you and your family can cherish your loved one’s final days to the fullest and offer each other loving support during a trying time.

Caring for a terminally ill loved one is often equal parts rewarding and exhausting – physically, mentally, and emotionally. There are some amazing days where you make meaningful memories that will last a lifetime. Other days challenge you to the end of your endurance. To help caregivers stay balanced and prevent caregiver burnout, respite care is available to help.

What is Respite Care?

Respite care is short-term, in-patient care, designed to give family caregivers an occasional break to re-charge and rejuvenate. In many cases, Medicare benefits pay for patient transport and up to five (5) consecutive days of in-patient care at a Medicare-approved nursing home, hospital, or hospice facility. You can use respite care more than once, but only once during each benefit period. In case the term “benefit period” is unfamiliar, it refers to a 90-day period of care that your loved one can receive before they must re-certify that they are still eligible for hospice care.

Also, while many insurances (including Medicare) help cover this type of care, there may be a minimal cost to the family. Check with your insurance provider before entering into respite care.

Why Would I Request Respite Care?

Being a primary caregiver is an admirable undertaking. Caregiving takes strength, patience, and perseverance. It is not an easy task, and the demands on your time can pile up quickly.

With the challenges of caregiving, you might request respite care for many reasons, including:

Taking a Break

Caring for a dying loved one requires a lot of time, energy, and commitment. Over time, you may begin to experience “caregiver burnout” – physical and emotional exhaustion. With respite care, you can take a few days off to re-charge and care for yourself. This break provides an opportunity to rest and relax without worrying about the level of care your terminally ill loved one is receiving.

Focusing on Personal Health

Caregivers often neglect their own needs and are continuously giving their time, energy, and effort to caring for their dying loved one. Unfortunately, it’s not uncommon for family caregivers to experience depression, insomnia, changes in appetite, or become more susceptible to illness. Respite care gives you an opportunity to focus on your own health and wellness, so that you can come back with renewed energy.

Recovering from an Illness

Though this reason is similar to focusing on personal health, it’s more focused on sickness. If you catch a cold, the flu, or some other transmittable sickness, you definitely don’t want to pass that illness on to your terminally ill loved one. With respite care, you can take a few days to recover from your own sickness before returning to care for a loved one.

Attending Important Events

Life keeps moving forward, even when someone you love is dying. That means, there may still be weddings, graduations, or other events that you must attend. With respite care, caregivers can take a few days to attend these events without worrying about medical care.

Getting Increased Care for Your Loved One

Throughout the hospice journey, your loved one will experience ups and downs with their health. There will be times when their pain and symptom management is too much for you to handle on your own at home. During these times, you can request in-patient care where your loved one can receive the medical care they need for more severe symptoms.

Now that we’ve discussed a few reasons why you might request respite care, let’s talk about the benefits.

How Does the Caregiver Benefit from Respite Care?

For those who still aren’t sure about taking time away from a loved one, here are some of the biggest benefits caregivers see when they take advantage of respite care.

• Improved sleep
• Increased energy
• Improved outlook
• Reduced levels of stress and anxiety

Requesting respite care may feel like claiming a weakness or demonstrating that you don’t have what it takes to care for a loved one, but that couldn’t be further from the truth. The reality is – what you’re doing is hard and exhausting. Knowing your limits and taking time to care for yourself is a good thing. It will give you the energy you need to provide better quality care for your loved one and be at your best when they need you most.

How Does the Patient Benefit from Respite Care?

While respite care may seem like it mostly benefits the caregiver, there are also many benefits to the patient, including:

• Reduced guilt over their caregiver’s stress or anxiety; glad to give their caregiver a break
• Increased social interaction opportunities
• Improved relationship to caregiver; stress affects both the caregiver and the patient

It’s beautiful and good to receive care at home from a loved one, but at times, everyone needs a break. With respite care, both caregiver and patient can come back together more refreshed.

How Often Can I Request Respite Care?

With hospice care, there are benefit periods, and you can request this type of care once per benefit period. Under special circumstances, you might be able to receive additional respite care, but you will likely need supporting documentation to ensure the request is valid.

Every caregiver’s life comes with its challenges. If you just can’t provide the at-home care necessary for a dying loved one, consider looking into another living situation. Perhaps a different family member can step in to assist or you can look into care at a hospice facility or nursing home. To learn more about the options, go to “4 Places Where You Can Receive Hospice Care.”

But remember – to the hospice team, your loved one’s wishes always come first and supersede anything else. Be sure to discuss the options with your loved one before talking to the hospice team about any changes in location of care.

How Do I Request Respite Care?

If you’d like to request care, the best thing to do is talk to your hospice care team. They will help you prearrange dates for respite care and ensure that all the details are taken care of. If you aren’t sure when it would be a good time to be away, the hospice team can assess your loved one’s medical situation and give you guidance on timing.

Now that you understand the value of respite care – to both the caregiver and the patient – don’t be afraid to use this beneficial service for your well-being.

If you or a loved one have been dealing with an illness for a while, the words “hospice care” may strike your heart with fear and sadness. You may feel overwhelmed or out of your element as you hear new terms and definitions, but that’s okay. Take a deep breath. You will learn what you need to know.

To help you get started, we’re going to discuss the four main places hospice care is provided, so you know what the options are and can discuss them with your hospice care team.

The Purpose of Hospice Care

Before we begin, it’s important to realize that the hospice team is designed to support and guide the family as they care for a loved one during his or her final days. Family members (and friends) are the main source of care for the patient at home, but the hospice staff is available to help with additional care needs, including pain management and symptom relief. The ultimate goal of hospice care is to allow a person to die comfortably and with dignity at home, surrounded by people they love.

Now, let’s get started.

4 Places Where You Can Receive Hospice Care

Every hospice program is designed to give you access to a team of care professionals 24 hours a day, 7 days a week, no matter where that care is provided.

In general, care is provided at your “home,” wherever that home may be. However, as your specific needs and the severity of symptoms change, the place of care may change as well. Your hospice care team can help you determine which place may be the best option for your current health situation.

To learn more about the four levels of care that hospice provides and how each level may affect where you or a loved one receive care, make sure to read “Do You Know the Four Levels of Hospice Care?”

With that said, let’s talk about where you can receive hospice care.

1. At a Personal Residence

The most common place to receive hospice care is at a personal residence. This may mean a house, apartment, duplex, townhome, condo, etc. The hospice care team – made up of medical professionals, aides, and volunteers – will drop by for scheduled visits to check on the patient’s condition.

Most often, the hospice care team does not provide around-the-clock supervision – that responsibility falls on the family – but when needed, a hospice care member may stay for longer visits or even overnight.

2. At an Assisted Living or Nursing Home Facility

For some people, home may be an assisted living facility or nursing home. In this case, the facility may have specially trained nursing staff to care for hospice patients. Alternatively, they might decide to partner with a hospice provider in the area. For terminally ill patients who don’t have someone to care for them at home, an assisted living or nursing home facility is a good option.

A Quick Note Before We Move On

With hospice care, the primary goal is to allow a person to receive care in their own home. However, there are times when care at home isn’t enough. For these cases, you can receive hospice care at the following places instead.

 3. At an Independent Hospice Facility

In some cases, your hospice provider may have its own independent facility or “hospice house.” With its home-like atmosphere, a hospice house provides a comfortable place for in-patient, short-term stays when a patient needs around-the-clock care and supervision.

For the most part, a patient may stay at a hospice house if their symptoms have worsened and cannot be managed at home or they have requested respite care to give family members a break.

4. At the Hospital

At times, it may be necessary to receive hospice care while at the hospital. Depending on how the hospital has it set up, the patient may receive care:

• In a special hospice unit
• From a hospice team that visits patients on any nursing unit, or
• The medical staff at the patient’s current unit will act as the hospice team

Like a hospice house, there are two main reasons a person may receive hospice care at a hospital.

• Either pain and symptoms have progressed to the point of becoming unmanageable at home, or
• The family has coordinated respite care for a few days

The patient will return to at-home hospice care after respite care is complete or they feel comfortable enough to return home.

Remember…

Remember that you should always consult your insurance provider before making a change to the place of care. Most hospice benefits do not usually cover the cost of housing a patient in a nursing home or assisted living facility (also known as daily room and board costs), but these costs may be covered by traditional Medicare benefits or other benefits you have.

Hopefully you now have a better understanding of your options and can confidently converse with your hospice care team about your needs as they change.

On the hospice journey, every person’s life situation and illness are different. One person may have a large family that will split care duties, while another person may have one child and a close friend available to help. For one person, a terminal illness may manifest quickly while the same illness takes longer in another person.

Because situations are varied and could change at any time, Medicare (which covers the largest majority of hospice care expenses) requires that hospice care providers offer four levels of service. You may start the day at one level and be at another level later in the day as needs change, and that’s okay. Hospice programs are equipped to pivot and adjust quickly as things change.

Today, we’ll review the four levels (or “kinds”) of hospice care that are available to families.

1. Routine or Intermittent Home Care

More than likely, it is routine or intermittent home care that comes to mind when you think of hospice. With this level of care, nurses, aides, or therapists stop by the home for short, regularly scheduled visits. These visits are focused on pain management, symptom management, emotional and spiritual counseling for the patient and family, assistance with daily tasks, nutritional services, and therapeutic services.

Routine care takes place wherever the patient calls home. This could mean a residence, a skilled nursing facility, or an assisted living facility, to name a few options. Also, while visits are routine, if your family needs additional help, there’s a nurse on-call 24 hours a day.

2. Continuous Care

With continuous care (or crisis care), a hospice patient will receive nursing assistance for several hours at a time, or even overnight, during a time of medical crisis or intense symptoms. If the patient’s symptoms are severe, they will need more focused and frequent care, so the hospice worker will stay for longer periods of time.

If death is imminent, the hospice nurse may stay overnight or offer whatever support they can to the family. This type of round-the-clock nursing allows family caregivers the opportunity to step back from hands-on care and focus on simply being with their loved one.

3. In-patient Care

While it’s most common to receive hospice care at home, sometimes home nursing isn’t enough. If symptoms intensify or it’s become impossible to manage pain or symptoms at home, a hospice patient may receive in-patient care at a hospital, nursing home of their choice, or independent hospice facility (also called a “hospice house”).

The goal of in-patient care is to help a patient become stable enough that they can return home again. However, in some cases, the person chooses to spend their final days at the in-patient care facility rather than return home.

If the medical need that leads to in-patient care is related to a hospice diagnosis, your insurance’s hospice benefit will likely continue to pay the bills. With an unrelated medical issue, contact your insurance company to discuss what’s covered in your policy.

4. Respite Care

For caregiving family members, a terminally ill loved one’s physical needs can be demanding. To give family caregivers an occasional break, hospice providers offer in-patient respite care.

With respite care, the hospice patient is checked into a 24-hour personal care home. While there, the patient will receive round-the-clock care for up to 5 days. After 5 days, the patient returns home to receive either routine care or continuous care (as needed).

Though this level of care isn’t necessary for every family, it is available and covered by Medicare. Also, if your family needs respite care more than once, that’s fine, too. Just coordinate with your hospice team.

Who Determines Which Level of Care is Appropriate?

When you start using the services of a hospice provider, the hospice physician and nursing team will complete an assessment to determine which level of care is appropriate at that time. As symptoms change, the hospice medical personnel can keep tabs on the hospice patient’s status. They can adjust levels of care as needed.

However, don’t think you have to wait on the doctors to take notice. If you see a need to update your level of care, don’t be afraid to ask. Be proactive and talk to your hospice team about updating your care routine.

If you have more questions about the four levels, contact a local hospice provider and start getting answers. While there may be four “levels,” the best part is that no matter which level of care you or a loved one receive, the hospice philosophy will not change: to provide expert medical care and emotional support that respects the unique wishes of the patient. From the moment you begin a hospice care program, your family will be in good hands.