When should a decision about entering a hospice program be made and who should make it?

At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.

Should I wait for our physician to raise the possibility of hospice, or should I raise it first?

The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.

What if our physician doesn’t know about hospice?

Most physicians know about hospice. If your physician wants more information about hospice, it is available from the National Council of Hospice Professionals Physician Section, medical societies, state hospice organizations, or the National Hospice Helpline, 1-800-658-8898. In addition, physicians and all others can also obtain information on hospice from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration.

What does the hospice admission process involve?

One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Most hospices have medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.
The so-called “hospice election form” says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.

Is caring for the patient at home the only place hospice care can be delivered?

No. Hospice patients receive care in their personal residences, nursing homes, hospital hospice units and inpatient hospice centers.

Is hospice affiliated with any religious organization?

No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.