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Options for Care

When an individual enters the final stage of life, there are many questions that must be answered. Let’s look at each of these questions.

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Can the individual continue to live at home?

The patient’s primary physician, the hospice Medical Director and RN Case Manager will be able to assess the patient’s condition and provide advice on the level and amount of care that will be needed.

In the hospice environment, primary care normally is provided by a family member or another caregiver who may be a spouse, a significant other or a friend. The vast majority of hospice patients we serve are cared for in this manner. In some instances, the patient or family may choose to supplement care by using privately paid companions.

Remember that hospice care under the Medicare Hospice Benefit is provided at no cost to the patient or family. However, you must also remember that the Medicare Hospice Benefit does not include reimbursement for routine continuing patient care, such as companion care, attendants or homemakers. Private insurance companies may provide some coverage for these services, but you will need to discuss your coverage with your insurance company.

If private insurance coverage is not available, then private care is an option, but the patient or family will be responsible for the costs incurred to employ private caregivers. The cost will depend on the amount of private pay care that the patient or family may elect to use, since all other services, drugs, medical supplies and medical equipment are provided by Medicare through the hospice agency.

In some cases, the patient’s condition ultimately may require a level of care or an amount of care that the caregiver and family cannot provide. If the patient, family or patient’s representative determine that the patient can no longer be cared for at home, then the options described below should be considered. However our Social Workers will work in conjunction with your family to ensure your loved one will fully benefit from all the resources.

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If adequate care cannot be provided in the home, what are the options?

In-Patient Hospice Units
There are a number of options for utilization of IPU in our area for short-term management of symptoms unable to be managed at home. In-Patient Units can be used for short-term respite as part of your Medicare benefit.

Costs of Nursing Homes and Residential Assisted Living Facilities
Residential assisted living facilities and nursing homes are private pay facilities, meaning the resident must pay a monthly fee to live there. The Medicare Hospice Benefit does NOT include a provision for paying the monthly room and board costs to live in these types of facilities.

Under certain conditions, Medicare does provide coverage for nursing home care, if the patient enters the nursing home directly from the hospital. However, this is not, and should not be confused with, hospice care coverage under the Medicare Hospice Benefit.

So, where is the best place for a hospice patient to be… at home, in a residential assisted living home or in a nursing home?
Only the patient or the patient’s representative and family can make this decision.

However, if your choice becomes limited to a nursing home or an assisted living facility, the best way to evaluate the difference between facilities is simply to visit several facilities of each type. As with choosing a hospice, you should meet the staff members in each type of facility so you can determine who will provide the best and most personalized care.

Entering a nursing home or assisted living facility does not preclude the use of hospice services. Hospice of the Sacred Heart will provide care wherever you call home. The differences between these types of facilities will be immediately obvious and will allow you to make an informed decision that is in the best interests of the patient.

If you have immediate questions or comments, please call us.