FREQUENTLY ASKED QUESTIONS

Q:  Does Hospice mean we are “giving up” on our loved one?
A:  When a patient is admitted to hospice, it usually means there is no further curative treatment to offer. That does not mean, however, that all treatment will be discontinued. The focus is now on improving quality of life, encouraging the patient to live life to the fullest until the end. Aggressive pain and symptom management will be provided to your loved one in order to ensure a peaceful death. In addition to managing physical pain, there are counselors who address emotional and spiritual issues of the patient and family.

Q:  Should I tell my loved one he/she is dying? I don’t want to depress him/her further. I am also afraid the hospice team will talk about dying all the time.
A:  The hospice team will answer questions concerning death when asked, at time of admission to hospice, or when plans or decisions need to be made. Hospice staff members encourage families to be honest with the patient about about the terminal prognosis. This is a time for the patient and family to discuss issues that may need to be resolved before the patient dies. It is a time to share memories and to allow the patient to reflect on his or her life. When family members attempt to keep secrets from patients, it often promotes a lack of trust. More often than not, the patient is already aware of his prognosis, but doesn’t want to say anything for fear of causing emotional pain to his family. Don’t be afraid to be honest with your loved one and say the things that need to be said.

Q:   Is hospice only for people with cancer?
A:  It is true that more than half of our patients receiving hospice care have a diagnosis of cancer; however, patients with any end stage disease can qualify for hospice. Some diagnosis we care for include end stage heart, lung, liver, and kidney disease, Alzheimer’s disease, end stage ALS and AIDS, just to name a few. Patients are referred to hospice care when they continue to decline after receiving optimal therapy for their condition. Anyone facing a life-limiting illness may be eligible for hospice care.

Q:  A criteria for admission to hospice is a prognosis of six months or less. What if the patient lives longer than six months? Will he/she be discharged from hospice?
A:  Hospice can care for patients as long as they meet the criteria. It is the responsibility of the hospice team to continually monitor the patient’s appropriateness for hospice. It is not uncommon for patients to “improve” under the care of the hospice team. This occasionally occurs due to the aggressive pain and symptom management provided by experts in palliative care. Often, when debilitating symptoms are controlled, quality of life improves and the patient feels like living again. In fact, our hospice team has discharged patients who have experienced a significant level of improvement and no longer meet the criteria for hospice.

Q:  Is it true that hospice uses drugs to hasten death?
A:  The goal of hospice care is to increase comfort while allowing the natural dying process to occur. This is often done through the use of medications which provide symptom relief without sedation. Family members are educated on how to assess their love one for pain and how to safely administer medication. Often times when a patient is provided with pain control, their bodies and minds “relax” and death may occur. In these cases, death was already imminent. The difference is the patient experienced a comfortable death, free of pain.

Q:  My dad wants to die at home. What if I am not able to care for him?
A:  Our team understands that concern and can offer support to not only the patient but to you and your family. As the disease progresses, the hospice team will educate you about how to meet the special needs of your dad. Should a situation warrant additional care, the hospice team is able to offer respite care in the case of “caregiver burnout” and continuous care during a medical crisis. If you and your family feel the need to admit your father to a nursing facility, hospice will assist you with this, and is able to continue providing hospice care after the transfer to his new home.

Q:  My mother has been taking Morphine for 2 months now. Yesterday, her physician increased her dose because she was experiencing increased pain. Does this mean she is becoming addicted to morphine?
A:  Addiction occurs when a person takes medication to get a “high” or a psychological effect, not for pain. Morphine is recommended for moderate to severe pain and is safe when used as recommended. Over time, tolerance to the medication occurs, and an increase in the dose is required. This does not mean your mother is addicted. When providing pain management for our patients, we may need to increase the dose several times. The right dose of morphine is the dose it takes to control your mother’s pain.

Q:  Is hospice care expensive?
A:  Hospice is covered by Medicare, Medicaid, and most private insurance. Medicare and Medicaid Hospice Benefits cover all hospice services related to the terminal diagnosis, and requires little, if any, out-of-pocket expense. Private insurances pay differently and out-of-pocket expenses for the patient and family may vary. In this case, the patient will be informed of any possible costs, upon admission to hospice.

Q:  Is it too early to call hospice if my brother is not experiencing pain or other discomforts? Should we wait until our brother has only a few days to live before calling hospice?
A:  No to both questions! Hospice care not only manages physical suffering. Hospice care is designed to maximize the quality, relationships, and experience at the end of one’s life. When a patient is being told there is no further curative treatment, a referral to hospice should be made. When a referral is made in the last few days of a patient’s life, the full aspect of hospice care can not be really provided. It is possible to provide adequate pain and symptom management when death is imminent; however, the hospice team can not fully gain the trust of the family due to the fact that they can only focus on their loved one’s impending death.

Q:  If I am admitted to hospice, can I keep my own physician?
A:  It is your choice of whether or not you want to continue seeing your own physician. Hospice has working relationships with many of the area physicians. Hospice does need to be notified of new medications or treatment provided by your physician. If the hospice team does not agree with the treatment ordered, you may be responsible for some out-of-pocket expense.

Q:  Is it true that hospice will let my Mom starve to death?
A:  NO! As the disease progresses, your Mom’s appetite may decrease. This is part of the natural dying process. Her body does not need the calories that you or I need. The hospice team will help you to understand this and to be comfortable with the idea of your Mom not eating. When a patient is receiving nutrition through a feeding tube, hospice will not encourage you to discontinue the feeding. The team will, however, as the disease progresses, help you understand that, as evidenced by certain signs and symptoms, the feedings may no longer be beneficial for your mother. Hospice care is about choices and being comfortable with any decisions made!