Category

Hospice

Illustrates how an elderly woman receives hospice care at home

Where Can You Receive Hospice Care?

By Hospice No Comments

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.

With a caring hand, shows how a nurse looks after an elderly patient

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 “What are 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.

Illustrates how an elderly woman receives hospice care at home

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.

Shows man receiving care at a hospital

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.

Shows a caring nurse looking at a patient while a family member looks on

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.

shows routine hospice care given at home

What are the Four Levels of Hospice Care?

By Hospice No Comments

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.

shows routine hospice care given at home

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.

Shows in-patient care

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.

shows man talking to his doctor about his health

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.

Man and wife receiving a doctor's care at home

What’s the Difference Between Palliative Care and Hospice Care?

By Hospice No Comments

If you or a loved one have recently entered hospice care, all of the jargon and terminology may feel daunting and foreign. For many people, two terms that often become confusing are palliative care and hospice care. Today, let’s break these two terms down so that you feel more comfortable and knowledgeable. After all, understanding what’s going on around you can help create a little bit of control in an uncertain situation. 

palliative care

What is Palliative Care?

First, let’s talk about palliative care and get a sense of what it provides.  

Definition

In short, palliative care refers to the day-to-day care and emotional support provided to someone with a life-threatening illness as doctors pursue a cure (age doesn’t matter). In other words, curative treatments and palliative care occur simultaneously.  

For example, a person dealing with a stage 4 cancer diagnosis will receive palliative care as they go through the treatments prescribed by their doctor. Palliative care begins with a diagnosis and only ends when 1) the person gets well or 2) it becomes clear that the person isn’t going to survive their illness.

Who provides palliative care?

The primary care physician oversees palliative care. When a person begins to receive care, a team is assigned to them. This team will work with the patient and their family to provide medical, emotional, physical, social, and practical support.  

The palliative care team is made up of doctors, nurses, social workers, nutritionists, and chaplains (based on the patient’s needs). Each member of the team focuses on different aspects of the patient’s overall well-being and care.   

Shows a male nurse providing palliative care

What is the purpose of palliative care?

Some illnesses and treatment plans take a harder toll on the body. Palliative care seeks to enhance a person’s life by focusing on quality of life – for both the patient and their family.  

Not only does palliative care focus on easing symptoms, the palliative care team also desires to help patients understand their treatment options so they can make the choices most appropriate for their specific needs.  

Where can a person receive palliative care and is it covered by insurance?

Thankfully, palliative care is available at many different types of facilities. You can receive it at hospitals, nursing homes, outpatient palliative care or specialized care clinics, or even at home.  

As for insurance, it’s best to check with your insurance provider, though many plans do include some form of coverage. If you are a veteran, check with the Department of Veterans Affairs to see if they might cover palliative care.  

How do I request palliative care? 

If you think palliative care is the best next step, your primary care physician can refer you to a palliative care specialist. However, if your doctor doesn’t mention it on their own, don’t be afraid to ask!  

Shows a woman with cancer requesting additional care

What is Hospice Care?

Now that you have a better understanding of palliative care, let’s compare it to hospice care. 

Definition

Hospice care refers to the care provided to those who have received a terminal diagnosis (often with a prognosis of six months or less). However, an illness’s timeline can change so it’s possible to receive hospice care for longer than six months, if needed. Hospice care focuses on pain and symptom management since patients in hospice care are no longer seeking a cure.  

Who provides hospice care?

Similar to palliative care, patients are provided with a hospice care team made up of doctors, nurses, social workers, nutritionists, volunteers, and chaplains (as needed) that provide a variety of services. However, hospice care is overseen by the hospice medical director rather than the person’s primary care physician. 

Regardless, everyone works together to ensure that both the patient and their family are receiving the holistic care they need. The team will visit regularly and is available by phone.  

Man and wife receiving a doctor's care at home

What is the purpose of hospice care?

Hospice care seeks to provide care, comfort, and quality of life to the person who is dying. At this point, the patient understands that their body is no longer responding to medical treatments. The hospice care team steps in to offer comprehensive care for medical, physical, practical, and spiritual needs.  

Additionally, the hospice care team provides much-needed assistance to family members and friends as they grapple with the day-to-day demands of caring for a loved one with a terminal illness.  

Where can a person receive hospice care and is it covered by insurance?

In most cases, hospice care is received at the home, but it is also available at assisted living and nursing home facilities, hospitals, and hospice centers.  

Both Medicaid and Medicare offer coverage for hospice care (as do most other insurance companies), but you will need to call to get the specifics of your particular plan. Again, if you are a veteran, don’t forget to check with the VA. 

How do I request hospice care?

If you confer with your doctor and decide not to pursue life-saving treatments, you can start talking about hospice care. Most often, the doctor will bring it up, but if not, ask. There are some minimal eligibility requirements you can read about here 

Shows patient receiving hug from caregiver

Let’s Recap

As you can see, hospice care and palliative care are quite similar. Both involve putting together a team of qualified professionals to assist a patient and their family medically, emotionally, physically, spiritually, and practically. Both involve easing pain and symptoms related to a life-threatening condition.  

The main difference between the two relates to ongoing curative treatment. With palliative care, the patient is still actively seeking a cure, while those in hospice care have exhausted all curative options and are focusing on quality of life. 

With these terms defined, hopefully you will feel empowered to ask for what you need when you need it. After all, both palliative care and hospice care options are available and will offer caring support during a difficult season of life.   

At home nurse helping female patient get out of bed, helping put on cardigan

What are the Eligibility Requirements for Hospice Care?

By Hospice No Comments

If you’re reading this, you or a loved one have either recently received a terminal diagnosis or have experienced a sudden decline in health. Most likely, your entire family is experiencing sadness, disbelief, extra levels of stress, and lots of emotional strain. To help you through this difficult season, hospice care may be just what your family needs. But what are the eligibility requirements? Who qualifies and how? Let’s take a deeper look.

Female nurse putting comforting hand on elderly man's shoulder

Two Basic Eligibility Requirements

1. Certification of Illness

A person is eligible for hospice if they have been diagnosed with a terminal illness and given a life expectancy of six months or less if the disease runs its expected course. The hospice medical director must agree with the doctor’s assessment.

When determining eligibility and certifying illness, the primary physician and hospice medical director often look for three indicators: 1) a patient’s lack of improvement despite treatment, 2) a patient’s goal becomes comfort rather than cure, and 3) acute health events, like heart attack or stroke.

Older man talking with doctor about health

Some common health symptoms that indicate a patient may qualify for hospice are:

  • Frequent hospitalizations in the past six months
  • Significant weight loss (10% or more) within the past 3-6 months
  • A change in mental, cognitive, and functional abilities
  • Increasing weakness and fatigue
  • Decreasing appetite or trouble swallowing
  • Inability to complete daily tasks, like eating, bathing, dressing, walking, etc.
  • Recurring infections or increasing pain
  • Insufficient hydration or nutrition
  • A desire to stop treatment or to not go to the hospital

With some illnesses, especially those that are long term, the primary physician and hospice medical director will look for specific symptoms to help them determine if an illness has reached an end stage. This includes illnesses like ALS, Alzheimer’s and dementia, lung, heart, or liver disease, HIV/AIDS, cancer, neurological conditions, sepsis, and renal failure.

Let’s move on to the second eligibility requirement.

2. Focus on Comfort Rather than Cure

After an illness has been certified, there is one more eligibility requirement. Before a hospice care team can step in and begin to help the family, the terminally ill person must state that it is their intention to seek palliative care instead of curative care. This means that all care will now focus on improving quality of life and relieving pain rather than on life-prolonging treatments.

For cases when the terminally ill person is unable to communicate or make decisions regarding their own treatment, the person holding a Medical Power of Attorney (often a close family member) can make medical decisions on their behalf and initiate the hospice request.

However, please note that you can stop hospice care at any time. If life expectancy improves or new treatments become available, you can stop hospice care and begin to focus on curative care.

At home nurse helping female patient get out of bed, helping put on cardigan

Alternatively, if hospice care isn’t working out for your family for whatever reason, you can stop it and do something else that may work better for your particular situation. If you need to re-enter hospice care at a later date, you can. Just have your doctor and the hospice medical director re-certify the illness.

Once your eligibility is confirmed, you can begin receiving services from your hospice care team. Care usually takes place at your home, but your insurance may cover other options so make sure to ask. To learn more about the basic services available to you through hospice, click here.

What if You Need Hospice Care for Longer than 6 Months?

Great question. Doctors don’t know exactly how an illness will affect each person individually. Because of this, a prognosis of six months may turn into a longer period of time. Hospice prepares for that.

Hospice care is broken up into benefit periods. You can receive hospice care for two 90-day periods, followed by an unlimited number of 60-day periods. However, at the end of every benefit period, doctors reassess and recertify that hospice care is still needed.

Nurse sitting at older mans' bedside, holding hand and smiling

If the end of a benefit period is approaching, start the reapplication process 30 days before the next period is set to begin. That will give you time to get everything approved, ensuring there is no lapse in care.

Now that you better understand how hospice eligibility works, please talk with your own or your loved one’s primary physician to determine next steps.

Please NOTE: These eligibility requirements are based on Medicare’s Hospice Benefit. Medicare pays for more than 85% of all hospice fees in the United States. If you have a different health insurance provider, check their eligibility requirements.

Nurse helping elderly woman move with walker

What Services Does Hospice Provide?

By Hospice 2 Comments

If you’ve never had to look into hospice care before, you may feel a little out of your element. One of the big questions on your mind may be, “What exactly does hospice do? What kind of services do they offer?” Today, we’ll take a look at the variety of standard offerings available through hospice and how they benefit your family.

Before we get started, it’s always helpful to have a definition of hospice care. At its core, hospice care is about taking care of patients and their families with kindness and compassion. It focuses on creating a comfortable, pain-free environment for the terminally ill, making each person feel confident that they know what to expect, and offering supportive care to family members.

Younger person holding older person's hands, focus on hands only

First Things First

Once a terminally ill person enrolls in hospice care, they will begin receiving visits from their hospice care team. This team can include a wide variety of people, depending on the hospice services your family pursues.

The team could include a nurse, hospice aide, social worker, chaplain, bereavement coordinator, physical, occupational, speech, or dietary therapists, spiritual and/or grief counselors, and volunteers – all overseen by the hospice medical director.

However, the services your family receives will depend on your specific needs. Adjustments are made to accommodate each individual patient and their family. So, if you don’t want or need a dietary therapist right now, you don’t have to have one. But if your needs change, you can always request a dietary therapist later. Hospice care is very personalized and can be tailored to fit a family’s specific needs over the duration of a person’s terminal illness.

Nurse helping elderly woman move with walker

7 Basic Hospice Services

The most common way to pay for hospice is with Medicare (85.4%), followed by private insurance (6.9%), Medicaid (5%), and other options, including self-pay (2.7%). Because Medicare is used most often to pay for hospice, its benefit rules are used by Medicaid and other insurance plans as a base line. In other words, other insurance companies base their hospice benefit plans on Medicare.

That’s not to say there aren’t differences, but by reviewing Medicare’s hospice benefit policy, we can get a good look at what services are most commonly available across the country. NOTE: Some hospice providers will include their own personalized services in addition to these basic services, so make sure to ask if there are any additional services available.

1. Personal & Medical Care

Of course, every hospice patient will receive medical care. However, it’s important to understand that this is not curative care. Instead, it’s focused on managing pain and symptoms so that a hospice patient’s final days are as comfortable as possible. This includes services from doctors and nurses as well as prescription medication.

The hospice care team will closely monitor the hospice patient’s needs and create a treatment plan that meets both your end-of-life care preferences and provides optimal comfort.

Female nurse taking elderly man's blood pressure at his home

2. Medical Supplies & Equipment

Secondly, hospice will provide medical supplies and equipment that may be necessary for pain relief and symptom management. This could include a walker, wheelchair, oxygen tank, hospital bed, bandages, catheter, bedpan, wound care supplies, and much more.

The hospice care team will arrange for both the delivery and removal of all such items. If there is something you need, communicate that to the care team, and they will work with you to ensure that the hospice patient’s needs are met.

3. Therapy & Nutrition

While it may not come to mind at first, hospice will coordinate physical therapy, occupational therapy, speech therapy, and even dietary counseling. If these services are deemed medically necessary by the hospice medical director, then they will be provided to the hospice patient. For example, if a person has trouble swallowing, speech therapy can help.

As for nutritional care, as the hospice patient’s body begins the dying process, they may not be able to process as many calories, digest properly, or process food or drink at all. With dietary counseling, family members are given the information needed to know when and how to make adjustments to diet and ensure that a loved one’s food intake is correct.

Nurse holding patient's hand, who is lying in a hospital bed in their home

4. Assistance at Home

As the hospice patient’s illness progresses, it will become even harder to take care of daily tasks. That’s why the hospice team is also available to help with eating, toileting, bathing, dressing, changing bed sheets, and more. The team’s highly trained nurses or aides will perform these tasks with care, discretion, and dignity. Plus, by doing these things, the hospice care team allows the family caregiver to take a break.

Talk with your hospice care team to find out what kind of at-home assistance they offer and request what best fits your needs.

5. Social Work Services

Here’s one you may not have heard about – social work services. You will have a hospice social worker assigned to you who will provide support by connecting the family to additional financial support programs or psychosocial support available in the community.

Some common social work services include:

  • Providing information about grief counseling and coping skills
  • Planning for discharge
  • Coordinating care
  • Helping families navigate the hospice care system
  • Advocating on the family’s behalf
  • Assisting survivors with arrangements and paperwork

Basically, the hospice social worker is there to guide your family through the hospice care process from beginning to end. Think of them as an incredible resource for questions and solutions.

Group support group

6. Counseling

Another big part of hospice care revolves around counseling, both for the hospice patient and their family. This could include emotional and spiritual counseling, grief counseling, and psychosocial counseling.

Spiritual & emotional counseling – There are skilled counselors available to help each person in the family achieve peace in their heart and spirit prior to the death. For some, this may mean seeking to restore broken relationships, mend hurt feelings, or draw closer to loved ones.

Grief counseling – After a terminal diagnosis, everyone knows that death will come sometime in the near future, and with death, comes grief. To support families through the ups and downs of grief, hospice makes grief counselors available to provide comfort, both before and after the loss of a loved one.

Psychosocial counseling – Receiving a terminal diagnosis takes a heavy toll, often bringing out depression or severe anxiety. Psychosocial counselors seek to help the hospice patient understand the end-of-life process and work toward social and emotional restoration.

At home hospice nurse sitting with patient, giving a hug as they look out the window

7. Respite Care

One final service to review is respite care. Every family will have a primary caregiver, and it can be an exhausting role. To give family caregivers a much-needed, occasional break, the hospice care team will provide respite care.

Most often, this means that the hospice patient will be placed in an in-patient facility for a few days, giving both the caregiver and the hospice patient a break. If this is something your family caregiver needs, contact your social worker, who can arrange this for you. You can get respite care more than once, but only on an occasional basis.

These are the basic services you can expect to receive from a hospice provider. Of course, don’t forget to ask if your specific hospice provider includes additional benefits. As you walk down this road, remember that you aren’t alone, and there’s an entire team of people waiting to help you through it.

Older man and wife standing at kitchen counter looking over documents

7 Ways to Pay for Hospice Care

By Hospice No Comments

Facing a terminal illness brings many worries and concerns but paying for end-of-life care shouldn’t be one of them. Thankfully, there are many ways to pay for hospice, and many of them are free. Let’s take a look at 7 ways to pay for hospice care. Then, you can decide which options work best for your family and specific situation.

First, it’s important to note that hospice care refers to care and support in the final stages of illness. It focuses on quality of life and comfort rather than curing an illness. If you or a loved one are still trying to cure an illness, then it’s not time for hospice care. Now, let’s get started.

Older man and wife standing at kitchen counter looking over documents

1. Pay with Medicare (Ages 65+)

If the terminally ill person has Medicare coverage, then the Medicare Hospice Benefit should cover the vast majority of expenses (often 100%) if you use a Medicare-approved hospice provider. Thankfully, more than 90% of all hospices are certified by Medicare, so you should have no trouble finding one.

While there are eligibility requirements, if you qualify, then the Medicare Hospice Benefit will cover (to name a few):

  • All items and services needed for pain relief and symptom management
  • Medical, nursing, and social care and services
  • Drugs for pain management
  • Additional levels of service if needed
  • Durable medical equipment for pain relief and symptom management
  • Supplies, such as catheters or bandages
  • Aide and homemaker services
  • Speech, occupational, and physical therapy
  • Short-term inpatient care or short-term hourly care
  • Respite care (to provide primary caregiver with relief; small co-payment may be required)
  • Spiritual and grief counseling for you and your family

However, it’s important to note that the Medicare Hospice Benefit will not pay for treatments or prescriptions aimed at curing a terminal illness, room and board, services from a second hospice team (you must receive care from just one hospice team), and any inpatient/outpatient care or ambulance services you receive that are not arranged by your hospice (or are unrelated to your terminal illness).

To learn more, go to Medicare’s Part A coverage on their website.

Woman visiting her doctor, getting blood pressure taken

2. Pay with Medicaid (Select Groups)

While Medicare is administered by the federal government and the rules are consistent throughout all U.S. states, Medicaid is a little different. Medicaid is funded by both state and federal monies, and each state is given flexibility to set their own eligibility requirements.

To that end, where you live plays a key role in determining your eligibility for Medicaid coverage.

Additionally, if you or a terminally ill loved one decide to move to a different state (perhaps to be closer to family), you must re-apply for Medicaid in your new state. Medicaid coverage doesn’t transfer from state to state.

Generally, Medicaid aims to assist low-income individuals, families, seniors, and people with disabilities. Medicaid offers similar services as Medicare, including:

  • Nursing and physician services
  • Counseling services
  • Medical appliances and supplies
  • Medication for symptom control and pain relief
  • Home health aide and homemaker services
  • Physical, occupational, and speech therapy

It’s possible to have dual coverage – both Medicare and Medicaid. If this is the case for you, you can use Medicaid to cover costs that Medicare doesn’t.

The best thing to do when using Medicaid to pay for hospice care is to call your State Medicaid Agency and find out if you meet their eligibility requirements for hospice care. Click here to see a full list of contact information for State Medicaid Agencies across the United States.

Man sits on couch while talking on the phone, learning about insurance benefits

3. Pay with Private Insurance (Any Age)

If you are not eligible for Medicare or Medicaid, but you do have a work-based or private insurance plan, contact your health insurance provider to determine what your insurance plan covers.

Though private insurance plans vary greatly, many plans do provide at least some coverage for hospice care. However, keep in mind – even if your plan does offer some hospice care benefits, they may have limits on hospice expenses. This is why it’s so important to contact your provider to get a clear image of what options are available to you.

Additionally, your insurance provider may have specific eligibility requirements you must meet before you can access hospice care benefits. Make sure to ask about these requirements. At the very least, most insurance providers will require 1) a certification of a terminal illness from an attending physician, and 2) confirmation that the terminally ill person has elected not to seek curative treatments.

If your insurance plan does not cover the full cost of hospice care, there are other options to help your family supplement the cost of care.

4. Pay Using Veterans’ Benefits/Tricare (Any Age)

If you are a veteran, the Veterans Administration can help pay for hospice if you are enrolled in the VA Standard Medical Benefits Package. As long as you meet the clinical need for hospice services, you are eligible regardless of age. A few highlights of this coverage include:

  • Care available at your home, nursing home, assisted living, or wherever you call home
  • No co-pay for hospice care
  • Medical equipment, medication, and personal care supplies
  • Pain and symptom management
  • Care coordinated with your doctors
  • Physical, occupational, and other therapy services
  • Spiritual care and support
  • Volunteers with military experience (when available)
  • Ongoing grief counseling for patients and family

To learn more about utilizing your VA benefits to pay for hospice care, contact your VA social worker and discuss your options.

Family of 6 standing in living room, draping American flag on their shoulders

For veteran spouses and children, CHAMPVA for Life is a health insurance program available to the spouses and/or children of veterans killed in action or permanently disabled. It covers most medically necessary care for individuals who are 65 or older, including hospice. To learn more about CHAMPVA, click here.

NOTE: If you or a loved one are a veteran, also look into veterans’ burial benefits. These benefits include burial and plot allowances to offset the cost of a funeral or memorial, free headstone and burial flag, military honors, and if desired, burial in a national cemetery (at no cost to the family).

5. Pay with Crowdfunding (Any Age)

If you have a large support network, then creating a crowdfunding campaign may be a viable option. GoFundMe is one of the most common platforms. On sites like this, you can share about your health journey and invite others into your final days.

While it’s best not to count on crowdfunding as a primary source of financial help, it can definitely make a dent in the cost of hospice care for yourself or a loved one. Additionally, there are foundations out there – like Hospice Help Foundation – that are focused on offering financial assistance to families who need financial assistance to afford hospice care.

Two women talking to hospice nurse

6. Ask About Reduced Rates (Any Age)

If you’re uninsured or your available insurance just doesn’t cover the cost of hospice care, consider talking to your hospice care provider about reduced rates. Some hospice facilities offer free care for patients who lack the resources to pay. Additionally, hospices often seek out charitable donations, grants, or other community sources specifically so that they can assist families financially.

Even if the hospice cannot offer free care, they may be able to offer reduced rates or charge on a sliding scale. Either way, it doesn’t hurt to ask!

7. Pay with Personal Savings (Any Age)

While most people are unable to pay for hospice care out of pocket, if you are able to do so, it’s another way to pay for hospice. Of course, make sure that all other options available to you are exhausted before paying out of pocket. If you are eligible for benefits and services, it’s best to take full advantage of those options before taking a financial hit.

One person hugging a loved one, focus on shoulder and hands

If you or a loved one have received a terminal diagnosis and you are looking into hospice care, there are many options available to pay for end-of-life care. Look into each one to see if you qualify. Also, most hospice providers employ financial support personnel, who can answer any questions you may have as you determine the best way to pay for hospice services.

Hopefully this information has helped you better understand some of the most common ways to pay for hospice care and gives you a path forward on the hospice journey.

Older man sitting quietly on stone steps as he thinks

Processing & Accepting Your Terminal Diagnosis

By For Caregivers & Families, Hospice One Comment

You’ve just received the news you’ve been dreading ever since you had that first appointment: your medical condition is terminal. Right now, you may be feeling so many emotions – shock or disbelief chief amongst them. Even as you grapple with your feelings, you’re faced with an exceedingly difficult challenge: accepting that you are dying while striving to make the most of your days. In this article, we will discuss how to process the reality of your terminal diagnosis while also finding a way to continue to live fully even though you are dying.

Processing & Accepting the Reality of Your Diagnosis

The initial shock of your diagnosis may have faded, or it could still be front and center. Take a few days to allow the strength of your emotions to abate a little. Then, for both your own sanity and your family’s, start processing through your new reality so that you can make the most of your final days.

Person talking to doctor

1. Acknowledge You Are Dying

Acknowledging you are dying is the first step to living the rest of your life. If your illness was sudden or unexpected, you’re going to deal with shock, disbelief, or numbness at first. This is a natural and necessary response to painful news. Don’t try to deal with everything at once; take your time. At first, you will understand everything with just your head, but in time, you will come to understand it with your heart.

To acknowledge you are dying is to let go of the future. It is to live only in the present. There is no easy way to do this, and you will probably struggle with this every day. However, by acknowledging and not denying the reality of your coming death, you will open your heart and mind to the possibility of a new, rich way of living.

2. Question the Meaning of Life

Discovering that you are dying naturally makes you take inventory of your life. You have a right to have questions, fears, and hopes. Illness often establishes a new direction for our lives and makes us question some of our old habits. New thoughts, feelings, and action patterns will begin to emerge; embrace them. The unknown invites you to question and search for the meaning of your life, in the past, present, and future.

Older man sitting quietly on stone steps as he thinks

3. Accept Your Response to the Illness

Each person responds to news of terminal illness in their own way. You, too, will have your own response. You may feel fear, excitement, anger, loss, grief, denial, hope, or any combination of emotions. By becoming aware of how you respond right now, you will discover how you will live with your terminal illness. Don’t let others tell you how you feel. Instead, find people who encourage you to teach them how you feel. After all, there’s no right or wrong way for you to think and feel.

4. Respect Your Own Need to Talk or Stay Silent

You may find that you don’t want to talk about your illness at all. Or you may find that you want to talk about it with some people, but not with others. In general, open and honest communication is a good idea. When you make your thoughts and feelings known, you are more likely to receive the kind of care and companionship you need.

But if you don’t want to talk about your illness, don’t force yourself. Perhaps you will be able to open up more later on, after you have lived with the reality of your illness for a time.

Man and woman sitting at table, man comforts woman with hand on shoulder

5. Tell Your Family and Friends You Are Dying

As hard as it may be, your family and closest friends deserve to know that you are dying. Tell them when you feel able to. If you simply cannot bring yourself to tell them, ask a compassionate person you trust to share the news on your behalf.

Just as every terminally ill person reacts differently to a diagnosis, each family member or friend will react differently to your news. Some will sit in shock, cry, or refuse to believe it. Others will spring into helpful action by running errands for you, offering to clean your house, etc.

Many will not know how to respond. Because they don’t know what to say or do, or because your illness reminds them of their own mortality, they may even avoid you altogether. Please know that their apparent abandonment does not mean they don’t love you. Give them time to process.

Make sure not to neglect telling children. They, too, deserve to know. As with all people, children can cope with what they know. They cannot cope with what they don’t know. Be honest with them as you explain the situation in language they will understand. Don’t overexplain but do answer any questions they may have.

Woman sitting on couch with computer in lap, reading documents

6. Be an Active Participant in your Medical Care

Many people are taught to be passive recipients of the care provided by medical experts. But don’t forget—this is your body, your life. Don’t fail to ask questions that are important to your emotional and physical well-being out of fear that you will be “taking up someone’s time.”

Learn about your illness. Visit your local library and consult the medical reference books. Request information from educational associations, such as the National Cancer Institute or the American Heart Association. Ask questions of your doctor, home health or hospice nurses, and other caregivers.

If you educate yourself about the illness and its probable course, you will better understand what is happening to you. You will be better equipped to advocate for personalized, compassionate care. You may not be in control of your illness, but you can and should be in control of your care.

Older man pushing older woman in wheelchair, outside and smiling

7. Be Tolerant of Your Physical and Emotional Limits

Your illness will almost surely leave you feeling fatigued. Your ability to think clearly and make decisions may be impaired. And your low energy level may naturally slow you down. Respect what your body and mind are telling you. Nurture yourself. Get enough rest. Eat balanced meals. Lighten your schedule as much as possible.

8. Say Goodbye

Knowing you will die offers you a special privilege: saying goodbye to those you love. When you feel you are ready, consider how you will say goodbye. You might set aside a time to talk to each person individually. Or, if you are physically up for it, you might have a gathering for friends and family. Other ways of saying goodbye include writing letters, creating videos, and passing along keepsakes. Your survivors will cherish forever your heartfelt goodbyes.

9. Find Hope & Embrace Your Spirituality

When people are seriously ill, we tend to get caught up in statistics and averages: How soon will the illness progress? How long do I have left? These can be helpful to know, but they don’t always provide spiritual and emotional comfort.

Man and woman praying before a meal

Even if you are certain to die from this illness, you can find hope in your tomorrows, your next visit from someone loved, your spirituality. Hope means finding meaning in life—whether that life will last five more days, five more months, or five more years.

If faith is part of your life, looks for ways to express it. You may find comfort and hope in reading spiritual texts, attending religious services, or praying. Allow yourself to be around people who understand and support your religious beliefs. If you are angry at God because of your illness, that’s okay; it’s a normal and natural response. Find someone to talk to who won’t be critical of whatever thoughts and feelings you need to explore.

10. Reach Out for Support

While you may have been raised to be fiercely independent, confronting a terminal illness cannot and should not be done alone. As difficult as it may be for you, you must reach out to others, specifically the people you feel most comfortable with in stressful times. Give yourself permission to reach out for prayers, support, and practical assistance.

Hospice nurse helping older woman stand

Additionally, hospices are an indispensable resource for you. They are well-staffed and trained to help both the dying person and the dying person’s family. Their mission is to help the dying die with comfort, dignity and love, and to help survivors cope both before and after the death. Whatever you do, don’t isolate yourself and withdraw from people who love you.

You still have a journey ahead of you – as you learn to accept and live with your diagnosis. Hopefully, these words have given you hope and a place to start as you process through your feelings and decide how to live the remainder of your days with purpose and intentionality.

*Based heavily on a brochure by Dr. Alan Wolfelt called Helping Yourself Live When You Are Dying. Dr. Wolfelt is a respected author and educator on the topic of healing in grief. He serves as Director of the Center for Loss and Life Transition and is on the faculty at the University of Colorado Medical School’s Department of Family Medicine. Visit www.centerforloss.com to learn more about the natural and necessary process of grief and mourning and to order Dr. Wolfelt’s books.