Understanding Hospice

    Chanda Liebo, Director of Hospice Operations, and Kim Anderson, Inpatient Clinical Manager, Deaconess VNA Home Care & Hospice

    There are a many questions regarding hospice, such as, “What services are included?”, “How is it paid for?”, and more.  Below are answers to some of these most common questions, as well as additional information about why hospice is a wonderful service and resource for families when a loved one has a terminal condition.

    What is Hospice?

    Hospice care is appropriate for patients who have a terminal illness with a life expectancy of six months or less, and are no longer seeking curative treatment.  Hospice care is growing in both need and demand, as people are recognizing its value.
     
    This care is not only for the patient themselves, but also for the family and caregivers of the terminally ill person.

    There is also a misconception that hospice care is only for patients in severe pain, or who are no longer functioning in daily life.  We want to help a patient feel as well as possible, to live out their final weeks and months to the fullest.  We love to help them finish out a “bucket list”!

    Hospice care isn’t about “giving up” or “giving in.”  It’s about preparing for life’s final journey, and then living as well and as comfortably as possible in the time remaining.

    Considering Hospice Care for Yourself or Loved One

    As hospice providers, we want to be able to provide the care needed by patients and their loved ones with as much time as possible.

    Hospice care isn’t often discussed or considered until a patient’s final days or even hours.  If hospice care could begin sooner, the patient could have a better quality of life in their final weeks and months, and we could be of additional support (financial, caregiving, emotional, etc.) to the entire family. This is also a reason to begin hospice care when there is still time to build relationships that can help support family members after their loved one has passed.

    How is Hospice Paid for?

    Hospice services are covered by Medicare, and also by most insurance companies. To be eligible for Medicare/insurance-covered hospice care, the patient’s primary physician must certify eligibility for hospice care; the doctor also approves the plan of care and works closely with the hospice team during the benefit period. The hospice medical director is also available as a consultant to the primary physician.

    The hospice benefit (for eligible patients) covers the cost of medications, medical equipment and services provided by the hospice team. Deaconess VNA staff assists families in evaluating insurance benefits prior to starting hospice services.

    Hospice Services and Benefits

    Hospice services are provided in various settings, from various care providers. 
    These care providers include:
    • Hospice nurses
    • Home care aids
    • Social workers
    • Chaplains
    • Volunteers
       
    Also key to this team is the patient’s own physician(s) and our hospice medical director.

    In-home services

    In-home services are very broad, yet specialized and specific to each patient’s needs.  We can help patients and their families in a variety of ways.

    Our main role for in-home services is to provide support and hands-on education to the patient and family to help the patient live comfortably in their home, or wherever they call home.

    In-home services and coverage can include:
    • Home visits by hospice nurses, who help manage symptoms, and provide education and guidance for family/caregivers.
    • Home care aids, who can assist the patient and caregivers with activities of daily living, such as bathing, dressing, grooming, eating, etc.   They can also provide caregivers a brief break if needed.
    • Hospice nurses available by phone 24/7.
    • Home medical equipment needed for support to the patient, such as beds, oxygen, wheelchairs, and other necessary equipment.
    • Social services and case management to help coordinate non-medical needs, such as financial issues, final arrangements, and more.  These caring experts also help with challenging family dynamics and other support issues.
    • Medications prescribed by the medical director related to the terminal diagnosis, and for symptom management.
    • Spiritual support and visits from chaplains.
    • Bereavement and grief services (both during hospice care, and after the patient’s passing) for family and caregivers.
    • Many other services from caring hospice volunteers during special companionship visits.  Examples include pet therapy, reading, listening, playing games, music, helping to “fulfill last wishes” and other things that matter to the patient. 

    It’s important to note that all of these services are covered financially by Medicare and most insurances once a patient qualifies for hospice care and it has been accepted by the patient and his/her family.

    In-patient Hospice Services

    For hospice patients whose pain or symptoms cannot be effectively managed in the home setting, inpatient hospice may be an option.

    Reasons for needing inpatient care can include:
    • Symptoms out of control that need additional attention and care.
    • Respite care (up to five days) for when family caregivers need to be away for a major event or need a brief rest period.
    Sometimes, if a patient can’t be cared for in the home any longer, the hospice social work/case manager team will help work on alternate placement. 

    In-Patient Hospice Facilities

    The John and Betty Charlier Hospice Center (located within the Deaconess VNA building, near downtown Evansville), is a seven- room home-like inpatient hospice facility with numerous amenities for both patients and families, including:
    • A spacious family room with television, books, and computer with internet and social media capabilities.
    • A well-stocked family kitchen where loved ones may prepare meals for themselves or a special meal for the patient.
    • A beautiful meditation room for spiritual reflection.
    • A children's playroom complete with television, video games, books and toys.
    • Courtyard and garden view and access from each patient suite.
    • Specialized services such as music therapy, pet therapy and more.

    The Charlier Hospice Center is staffed with registered nurses and hospice aides 24 hours a day, 7 days a week. Other hospice team members visit the Center, depending on the needs and wishes of the patient and family. Family members may stay in the Center with their loved one around the clock. With adult supervision, children are welcome to visit; arrangements may also be made for a visit with the patient's pet.  A video tour is available. 

    Inpatient care is also provided in a dedicated hospice unit at Deaconess Hospital. Soon, the Linda E. White Hospice House will open (planned for January), which will be a hospice facility on the Deaconess Hospital main campus.  It will also include seven suites, and have many of the same features and amenities as the Charlier House.

    Bereavement Program

    Our Bereavement Program provides counseling and support to family members and loved ones who must go on with their lives after a loss. Bereavement is defined as the period of time during which people emotionally experience, respond and adjust to the death of a loved one.

    Just as each person is a unique individual, each individual may experience grief in different ways and therefore, need various types of support during this time.

    Our services are provided for one full year following the death and consist of mailings, a memorial service and support groups. The confidential monthly support group meetings (including a special group for men) give family members an opportunity to gain understanding of the grief process and their own grief reaction, discover ways of coping with loss, explore social opportunities and support systems with others experiencing loss and learn about additional resources.

    For more information, or answers to more frequently asked questions, please visit www.deaconess.com/VNA or by calling (812)425-3561.  
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