is a vital service that provides compassionate and specialized support to individuals with life-limiting illnesses, particularly when they choose to receive care at home. Understanding what home hospice covers is essential for patients and their families to ensure comprehensive and personalized end-of-life care. This article aims to shed light on the various aspects of home , including medications, durable medical equipment, staffing support, and the expertise offered in managing the natural dying process. By delving into these details, individuals can make informed decisions and better comprehend the valuable assistance that hospice care provides during this sensitive time.

Hospice at Home

It's a quite common question as to what hospice does provide when the patient is living at home. Let's go over the meat and potatoes.

1- Medications: All comfort medications and medications related to the terminal illness are covered by hospice. OTC, supplements, and medications not directly related to the terminal illness are typically handled as they were prior to hospice.

2- Durable medical equipment (DME) is typically covered by hospice for basic DME needs. I.e. electric hospital bed, oxygen concentrators (basic models), oxygen tanks, rollators, walkers, etc. Specialty equipment such as sit-to-stand chairs and electric/powered wheelchairs are not typically covered by hospice.

3- Support/Staffing: 24-hour per day availability without regard to weekends and holidays. CNA (certified nursing assistants — often mistakenly called a nurse BUT not a nurse!)/HHA to help with bathing, changing, light housekeeping (generally directly around the patient's area) as well as educating family members in how to do the same tasks when they are not present, RN case managers (RN CM) who come on-site to assess the current needs, provide education on the disease process and progression, medications, working with the patient's attending physician and the hospice medical director on changes to the plan of care, managing the entire care team, social workers to help with community resources as well as provide education, (often non-denominational) to provide spiritual and emotional support.

One of the most misunderstood areas of staffing and support is that none of us are onsite 24×7 with the patient, none of us work “blocks” of time (though Medicare's standards is to try to be with the patient and family for no less than 30 minutes). We visit, we do a set of assigned tasks, we work through any unassigned issues that are important to deal with before we leave, then we leave to see the next patient and family and so on. The can often provide information on how to obtain 24×7 support on-site but that is not financially covered by hospice itself.

4- IMPORTANT: We are experts in the natural death and dying process encompassing all terminal illnesses, /lack of comfort/pain issues your loved one and family will go through. Outside of palliative specialists, there are absolutely no substitutes for the expertise we bring to the table. There are times we unintentionally prolong the loved one's life because it is EXTREMELY common for medications not to be reviewed on a regular basis to determine if the medications are causing outright harm to your loved one and should be discontinued or modified. Good hospice professionals will sugar coat nothing, and help you know what to expect over time (not exact dates and times to be clear).

I cannot stress #4 above. Personally, I've case managed situations where the doctors did not have a clue how to manage the patient's pain where the hospice team got the pain so well managed the patient was able to go on a final vacation before passing, cases where the patient was so restless non hospice/ doctors were clueless to get the situation managed so the patient could come home and so on.

The word, “hospice” is a philosophy, not a location. The word, “hospice” is a philosophy, not one big organization. The word, “hospice,” is a philosophy, not a setup like EMS where there are strategically located buildings/locations (stressing the first sentence) from whom staff operate. There are typically two to dozens of hospice agencies servicing various geographic areas (though be careful that two separate agencies may still be owned by a larger corporation). It's always a clever idea to interview two or more hospice agencies to find out how they would manage your situation vs. just interviewing one. During the interview ask who owns the agency (i.e. Aseracare is owned by Amedisys (an extremely large public company focused on profit).

Conclusion

Home hospice care encompasses a wide range of services designed to prioritize the comfort, dignity, and well-being of patients with terminal illnesses. From covering essential medications and durable medical equipment to providing round-the-clock staffing support and expertise in managing the natural dying process, hospice care is tailored to meet the unique needs of each individual. It is important for patients and their families to be aware of the comprehensive nature of home hospice care, as this knowledge empowers them to make informed choices and ensures that their loved ones receive the highest quality of compassionate end-of-life support. By embracing the philosophy of hospice care and understanding its various components, individuals can navigate this challenging journey with the valuable assistance and guidance offered by hospice professionals.

Resources

The Importance of Caregiver Journaling

Reporting Changes of Condition to Hospice

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

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Take Back Your Life: A Caregiver's Guide to Finding Freedom in the Midst of Overwhelm

The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself

Dear Caregiver, It's Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout And Find Joy Again While Caring For A Loved One

Everything Happens for a Reason: And Other Lies I've Loved

The Art of Dying

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.

Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

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