Hospice Benefit Usually Not Understood

Today , like many days, I took a phone call from a family member who lives out-of-state, and I will paraphrase what she said, but it went something like this”I think when my relative needs more care, we will enroll in Hospice and have them provide the care.”  Unfortunately, this is one of the greatest misconceptions about a medicare Hospice benefit.  First of all, enrolling in Hospice is valuable and important.  Most Hospices that we are lucky enough to partner with in providing care wish that folk would enroll sooner rather than later.  The majority of Hospice benefits provide a team that will come to your home, that team typically involves a RN care manager (and symptom management expert for your comfort needs), a Social Worker (knowledgable about resources and terrific family support), a hospice bath aide (who will provide help with bath or shower a couple of times per week), a chaplain, and if the need arises a physical therapist or speech therapist.  Your team is well connected to your physician and works with you, your family, and your physician to give you the best quality of life possible in your place of residence.  A Hospice volunteer might work with you to provide reading and/or conversation.  Some Hospices provide homemaker shifts to tidy the house, do laundry, and help with cooking/errands.  However, the care that is needed on an hour to hour basis to help with safety supervision, dressing, walking, getting medication on a daily basis, daily meal prep, assistance with toileting or incontinence care, and/or helping you stay clean and comfortable when you begin to stay in bed is not typically provided by a Hospice benefit.  Occasionally a Hospice benefit will provide some of this care, but it is only when you have the right kind of supplemental insurance to your Medicare Hospice benefit or you have long term care insurance.  At CareForce we are called upon often to provide care to client’s enrolled in Hospice and family’s are often “shocked” that this kind of care is not included in their benefit.  It is one more stressor at a time when there are all of the emotional issues of changing treatment goals to those of comfort and finding quality of life. Many families have the luxury of enough family and friends to provide the care, but often this is not the case.   Our loving clients and families who we provide that care to will usually pay out of pocket for that care (except for the few who have that special Respite benefit).  Know your benefits, if you want to stay home through your Hospice stay, plan for it with your financial planner or family.  CareForce can provide you help to stay at home for the rest of your days, however you will likely pay out of pocket for the majority if not all of that care.  Once again, Medicare Hospice teams are wonderful and valuable; At CareForce we are honored to be a trusted referral source for those staying at home for the rest of their days, but be aware of your benefit, how family and friends can help and how you need to plan for your care at home.