Hospice is a service to support a terminally ill patient’s physical, emotional, social and spiritual needs. Hospice concentrates on managing a patient’s pain and other symptoms so that the patient may live as comfortably as possible and make the most of their remaining time. Hospice also supports the patient’s family and caregivers, including grief and loss counseling.
Another advantage of hospice is that a hospice nurse can declare death and facilitate transportation to a mortuary. If someone dies at home and you call 911 and there is no DNR, paramedics may attempt emergency procedures.
Typically hospice care is provided in the patient’s home, with the majority of the day-to-day care falling on family members and caregivers. As this article on the “Cost of Dying..” points out, ” hospice has ballooned into a nearly $19 billion industry. It’s now the most profitable service sector in health care, as the industry’s business model relies heavily on unpaid family caregivers.”
“As we increasingly see that we want to provide home-based care, we’re relying even more on caregivers. And it does take a toll.”
-professor Katherine Ornstein, who studies the last year of life at Mount Sinai Hospital
Medicare will pay a set fee to qualified hospices for care of those with a terminal illness with a prognosis of six months or less to live. To stay on hospice, Medicare requires documented continued decline. Medicare will cover medications related to the terminal diagnosis and medical equipment, but will not pay for treatments intended to cure a terminal illness or treatments unrelated to the terminal diagnosis. The Medicare hospice benefit does not cover room and board in a nursing home or hospice residential facility. Some hospices provide extra services such as aroma, music therapy, etc. Some hospices have volunteers for extra support.
If you have a Medicare Advantage Plan you may be limited to hospices approved by the Medicare Advantage Plan.
You have the right to change your hospice provider once during each benefit period.
Articles Related to Hospice
Hospices not complying with state law May 2, 2023Sixteen months after California began requiring health care providers, including home health agencies and hospices, to post on their websites their medical aid in dying policies, only a handful are complying. Click here to read KPBS’s story on hospices not complying with the law, including a video. Click Here to listen to the podcast. 16:32 mins.Hospice for Jimmy Carter – Letter to the S.D. Union Tribune by Faye Girsh March 27, 2023In 2015, Former President Jimmy Carter announced he had been diagnosed with metastatic melanoma (cancer) – found during a surgery on his liver – that had spread to his brain. After a series of hospital stays, he chose to enter hospice care at home in early 2023 and forgo medical treatment for his illness. The ...How Hospice Became A For-Profit Hustle December 1, 2022An eye-opening examination of the profit-driven hospice industry: Click Here to read a New Yorker (pay walled) article For more information on San Diego area hospices and which ones have complied with the state law on posting their medical aid in dying (MAiD) policy on their website, please refer to this San Diego hospice section.Hospices Have Become Big Business for Private Equity Firms, Raising Concerns About End-of-Life Care August 28, 2022“That makes dementia patients particularly profitable. Doctors have a harder time predicting whether a patient with Alzheimer’s disease or another form of dementia has less than six months to live, the eligibility criterion for enrollment. For-profit hospices enroll those patients anyway, Teno said, and stand to profit the longer those patients live. They tend to ...California Passes Major Hospice Reform Laws October 5, 2021The Inescapable Truth September 2, 2019Opponents of assisted dying often use as an argument that assisted dying is not necessary because good quality palliative care can alleviate suffering at end of life. This report from England concludes that 17 people a day suffer at the end of their lives, despite the best efforts of hospice and palliative care. In research commissioned for ...Hospice didn’t stop suffering. But what it did for us was priceless. March 27, 2019by Dheeraj Raina, MD, psychiatrist – Kevin MD – March 27, 2019 A physician explains the good death and the comfort that hospice provided to his young wife and their family as she was dying from cancer. “Two of the most emotionally essential services that hospice provided was a chaplain and a social worker specializing in counseling ...Even the best palliative care can’t always help September 19, 2013Neil Frances explains even the best palliative care possible simply can’t help alleviate intolerable suffering for some.Letting Go-What should medicine do when it can’t save your life? August 2, 2010By Atul Gawande – The New Yorker – Aug. 20, 2010 “Our medical system is excellent at trying to stave off death with eight-thousand-dollar-a-month chemotherapy, three-thousand-dollar-a-day intensive care, five-thousand-dollar-an-hour surgery. But, ultimately, death comes, and no one is good at knowing when to stop.” “People have concerns besides simply prolonging their lives. Surveys of patients with terminal ...