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Choosing a hospice: Finding the right program for you and your loved one

Choosing a hospice--finding your way

By Terre Mirsch

Hearing that a loved one will benefit from hospice care may result in a flood of emotions.

Perhaps the news that a loved one has a limited life expectancy was unforeseen and a departure from the hope for a cure that once occupied your thoughts.  Perhaps the suggestion of hospice care comes as a relief and provides hope that help will soon be available to provide much needed comfort, support, and care coordination.

Whatever the circumstance that leads to a recommendation for hospice there may be many questions that follow.  What is hospice care?  How can they help me and my loved one?  And how do I choose a hospice?  You may find that there are just a few hospice programs in your region, or you may find as many as 80 or more hospices to choose from.

The following questions may guide you in knowing what to ask and help you in making an informed decision when choosing a hospice provider:

  • Is the hospice program certified and licensed by the state or federal government?

Most hospices are certified by Medicare and licensed by the state where they provide care.  This ensures that certain rules are followed, required services are provided, and that Medicare or Medicaid will pay for services.

  • What other kinds of accreditation or certification does the hospice program or its staff have?

While not required, many hospices seek accreditation from national organizations that ensure the hospice meets quality standards.  Also, hospice team members may have certification in hospice and palliative care or in their profession.

  • Can I get references, or find out about any accreditation a hospice has?  

Yes. The National Hospice and Palliative Care Organization maintains a directory of all organizational members, providing information about certification and accreditation status as well as other important program information.

  • How long has the hospice been servicing your community?  Who owns or governs the hospice?

How long a hospice has serviced your community, and whether a hospice is not-for-profit, for-profit, faith-based, free-standing, or part of a health system may be important to you.

  • What screening and training do staff and volunteers receive?

Ask about the number of hours and content of initial training as well as the hospice program requirements for ongoing education of staff and volunteers.

  • What additional services or programs does the hospice offer?

Federal regulations require all hospices to provide nursing, social work, pastoral care, hospice aide, volunteer, and certain bereavement services.  Some hospices have additional services that may include complementary therapies, community bereavement programs and support groups, palliative care, veterans’ programs, pediatric care, or specialized volunteer programs, to name a few.

  • How does the hospice respond to calls and concerns in the evening, night, and weekend hours?

Ensuring that help is available to you at any time of the day or night to address your concerns and visit your home, when necessary, is critical.  Find out how the hospice will respond to these needs.

  • What will happen if the care can’t be managed at home?

While the needs of nearly all people can be managed in the home, knowing what other options are available for assistance in the event of medical crisis will bring you much needed peace of mind.  Some hospices have freestanding inpatient hospice units or houses, while others contract with local hospitals or nursing homes.

  • What measures does the hospice use to ensure quality?

Public quality reporting for hospice programs will begin within the next year.  Many hospices are already collecting data regarding certain quality measures.  Inquire about what measures the hospice collects, including how quickly pain and other symptoms are controlled and what actions the hospice has taken to improve in these areas.

  • Does the hospice measure family satisfaction with care?

Through a brief survey, many hospices ask family members for feedback about care in order to ensure excellence and improve where necessary.  Ask the hospice if they measure family satisfaction and how their results compare to other programs.

It is increasingly common for healthcare consumers to explore options and even interview providers prior to making care decisions.  Hospice is no exception.  Whether choosing between three hospices or 80, understanding what makes hospice programs similar and understanding how they may be different is essential to choosing a hospice that will meet the unique needs of you and your loved one.

2 Comments Post a comment
  1. Mike Belsito - eFuneral #

    Thank you very much for this post, Terre. This is very well thought out and no doubt, helpful. One other suggestion for individuals considering a specific hospice provider: ask your friends. While it’s true that some people might be uncomfortable talking about end-of-life decisions they’ve had to make for loved ones, some people find helping others in a similar situation to be completely gratifying. There’s no better reference to receive than from people you know and trust — whether that reference is a positive one or not.

    May 8, 2012

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  1. Understanding the Medicare hospice benefit | Caring with Confidence

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