Who is eligible for hospice care?
What services does hospice provide?
When should patients and families consider hospice?
Doesn't accepting hospice care mean giving up?
How is hospice different from other medical care?
How is VistaCare different from other hospices?
Who pays for hospice care?
What are the different levels of hospice care?
What if I choose hospice care and then live more than six months?
What if my condition improves?
How does hospice manage pain and other symptoms?
Don't pain control medications make people feel "doped up?"
What kinds of emotional and spiritual support does hospice provide?

Q: Who is eligible for hospice care?

A: The Medicare Hospice Benefit is available to all patients with the Medicare part A benefit and with a life expectancy of six months or less if the terminal illness or disease runs its normal course. The patient, of course, must choose to elect hospice, and the patient's eligibility must be certified by a physician (most often the hospice's medical director, together with the patient's attending physician). In addition, hospice care is covered by most Medicaid and commercial insurance plans.

VistaCare accepts everyone who meets those criteria, regardless of the patient's financial situation or insurance coverage.

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Q: What services does hospice provide?

A: Hospice includes the services of an interdisciplinary team of healthcare professionals:

• Physicians - Our Medical Directors work with your personal physician to build a comprehensive team of medical professionals who specialize in controlling pain and other symptoms of serious illness. Working together, our team develops a plan of care that is right for each patient's individual situation and needs.
  
  
• Nurses - VistaCare nurses are experts at managing the needs of each patient and can serve as a valuable resource in educating family members on how to assist in caring for their loved one. Our specially trained and experienced nurses develop and manage a specialized plan of care for each patient, focusing on the patient's individual needs and providing compassionate support to the entire family.
  
  
• Certified Nurse Assistants & Home Health Aides - These members of the VistaCare team provide personal care and help the patient and family with activities of daily living. They also provide companionship and valuable emotional support.
  
  
• Social Workers - Our team of social workers coordinates community resources and helps the patient and family with non-medical concerns. The social workers can help comfort and give support to family members, plan for the future, assist with making financial arrangements and ease other emotional difficulties.
  
  
• Chaplains - These individuals work to help patients and families cope with spiritual questions and concerns, either directly or by coordinating services with the patient's and family's spiritual counselors.
  
  
• Bereavement Coordinators - VistaCare has personnel available to help patients and families deal with grief through each phase of the process.
  
  
• Volunteers - These team members provide companionship and emotional support and offer help in a variety of ways.

Hospice also provides medications, medical equipment and supplies necessary to promote comfort at home or in other hospice settings. Hospice staff are available at all times, 24 hours a day, 365 days a year.

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Q: When should patients and families consider hospice?

A: After a diagnosis of a life-limiting illness, patients and their families should consider their choices for care. A patient does not have to be bed-bound or critically ill to be admitted to hospice. A VistaCare representative will be happy to talk with you about the hospice benefit.

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Q: Doesn't accepting hospice care mean giving up?

A: Hospice involves acknowledging that most diseases in their advanced form cannot be cured. It does not mean giving up hope. Hope is found in helping the patient and family achieve the highest possible level of physical comfort and peace of mind. Many hospice companies require patients to be "ready" for the end of life before receiving services. At VistaCare, you don't have to be ready. Hope means different things to different people, and we will walk by your side on the journey to live out what hope means to you.

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Q: How is hospice different from other medical care?

A: Hospice is focused on all of the patient's and family's needs. A coordinated team of hospice professionals, assisted by volunteers, works to meet the patient's and family's emotional and spiritual needs, along with the patient's physical needs.

The emphasis is on controlling pain and symptoms through the most advanced techniques available and on emotional and spiritual support tailored to the needs of the patient and family.

Hospice recognizes that a serious illness affects the entire family as well as the person who is ill. The family, not just the patient, is the "unit of care" for hospice professionals. Sometimes other family members actually need more attention than the patient.

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Q: How is VistaCare different from other hospices?

A: VistaCare is the one of the largest hospice organizations in the United States, and the third largest in number of patients. Our Comprehensive Care philosophy is central to the way we practice hospice care. Many hospices require patients to have a caregiver at home, or to agree to give up expensive palliative treatments. VistaCare believes there should be no barrier to high quality end-of-life care, admitting any eligible patient who requests hospice care.

VistaCare is committed to the exceptional delivery of clinically sophisticated care. Company-wide standards exceeding industry norms have been implemented in all VistaCare programs, along with programs of professional development for staff and for education of family caregivers. VistaCare is committed to raising the benchmarks of hospice care nationwide.

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Q: Who pays for hospice care?

A: Hospice is covered by most insurance plans, including Medicare and Medicaid, with few, if any, out-of-pocket costs to the patient.

The Medicare hospice benefit covers costs related to the terminal illness, including the services of the hospice team, medication, medical equipment and supplies. Medicare reimburses for different levels of hospice care (see below) recognizing that sometimes patients require special attention.

• Medications. The Medicare hospice benefit covers medications needed to treat the patient's terminal illness. VistaCare will order the medications for you, and you can get them from the pharmacy or arrange for delivery. Medications for a condition not related to the terminal illness -- allergy medication, for example -- are not covered by the hospice benefit.
  
  
• Medical supplies. The physician and nurse will work with the family to determine which medical supplies and equipment the patient needs. VistaCare will order the equipment and have it delivered to the home.
  
  

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Q: What are the different levels of hospice care?

A:

• Routine Home Care - We believe in bringing care to wherever you call home, and we strive to provide an environment of care that is comfortable for our patients and their families. Often, this means providing care in the patient's own home, and our team of professionals schedule regular home visits to ensure that medical, social, and emotional needs are met.
  
  
• Inpatient Care - If pain or symptoms cannot be controlled at home, the patient might be taken to a hospital or other inpatient care center. When the symptoms are under control, the patient can return home.
  
  
• Respite Care - Many patients have their own caregivers, often family members. When caregivers need a rest from their caregiving responsibilities, patients can stay in a hospital or other inpatient care center for up to five days.
  
  
• Continuous Care - Sometimes a patient has a medical crisis that needs close medical attention. When this happens, we can arrange for inpatient care, or VistaCare staff can provide round-the-clock care in the home. When the crisis is over, the patient can return to routine care in the home.
  
  

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Q: What if I choose hospice care and then live more than six months?

A: Hospice care does not automatically end after six months. Medicare and most other insurers will continue to pay for hospice care as long as a physician certifies that the patient continues to have a limited life expectancy.

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Q: What if my condition improves?

A: Occasionally, the quality of care provided by VistaCare leads to substantially improved health. When this happens, VistaCare will transfer care to a non-hospice care provider. Later, if the patient becomes eligible for hospice, the patient can re-elect the hospice benefit. There is no penalty for getting better!

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Q: How does hospice manage pain and other symptoms?

A: Hospice physicians and nurses are experts at pain and symptom control. They are continually developing new protocols for keeping patients comfortable and as alert and independent as possible. They know which medications to use singly and in combination to provide the best results for each patient.

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Q: Don't pain control medications make people feel "doped up?"

A: When morphine and other pain control medications are administered properly for medical reasons, patients find much-needed relief without getting "high" or craving drugs. The result is that hospice patients often remain more alert and active because they are not exhausted by uncontrolled symptoms.

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Q: What kinds of emotional and spiritual support does hospice provide?

A: Hospice recognizes that people are more than a collection of symptoms. People nearing the end of their lives often face enormous emotional and spiritual distress. They are dismayed as their physical abilities begin to fail. They don't want to be a burden on their families. They worry how their loved ones will manage without them. Sometimes, they feel deep regret about things they have done or said - or things left undone and unsaid. Hospice professionals and volunteers are trained to be active listeners and to help patients and families work through some of these concerns so that they can find peace and emotional comfort in their final days.

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