Hospice care is focused on four main areas:
- Pain and symptom management
- Emotional and spiritual support for the patient, family, and loved ones
- Assistance in organizing a patient’s personal affairs
- Support in talking about the difficult issues that arise at end-of-life
To accomplish these goals, the vast majority of hospices follow the Medicare Hospice Benefit requirements to provide the services and equipment necessary to assure comfort, personal care, and emotional support for the patient, family, and caregiver(s). These requirements include:
- The time and services of the care team, which include visits to the patient’s location by the hospice physician, nurse, medical social worker, home health aide, chaplain/spiritual advisor, and volunteers
- Prescribing and dispensing of medication for symptom control or pain relief.
- Medical equipment like hospital beds, wheelchairs, and walkers, and medical supplies such as bandages and catheters.
- Physical and occupational therapy, as needed.
- Speech-language pathology services, as needed.
- Dietary counseling
- Any other Medicare-covered services required to manage pain and other symptoms related to the terminal illness, as determined by the hospice team.
- Short-term inpatient care (e.g. when adequate pain and symptom management cannot be achieved in the home setting)
- Short-term respite care by hospice volunteers (e.g. temporary relief for caregivers to avoid or address ‘caregiver burnout’ by providing trained individuals to stay with the patient so the caregiver[s] can do errands, go to appointments, or enjoy a few hours relaxing away from the home)
- Grief and loss counseling for the patient and loved ones, and bereavement counseling for caregiver(s) and family following the patient’s death
What Isn’t Covered Under Hospice Services?
Some treatments and services for patients enrolled in hospice care aren’t covered by the Medicare Hospice Benefit. These include:
- Treatment intended to cure the terminal illness or which is unrelated to that illness
- Prescription drugs to cure the illness or indicated for conditions unrelated to that illness
- Room and board in a nursing home or residential hospice facility
- Care received in an emergency room or inpatient facility and ambulance transportation unless it’s arranged by a member of the hospice team or is unrelated to the terminal illness