Hospice care focuses on comfort and dignity at the end of life; it involves care and support services that can be of great benefit to people in the final stages of Alzheimer’s and other dementias and their families.

What is hospice care?

Hospice is a special way of caring for people who are terminally ill—and for providing support to their family. The primary purpose of hospice care is to manage pain and other symptoms during the last six months of life where treatments focus on comfort rather than curing the underlying disease.

Hospice care is provided by a team of specially trained providers, including doctors, nurses, home health aides, social workers, counselors, clergy and volunteers. Family is often very involved in the care.

Examples of the care hospice teams provide include:

• Medical care to alleviate symptoms and pain (including medications and medical equipment).
• Counseling about the emotional and spiritual impact of the end-of-life.
• Respite care to allow caregivers relief.
• Grief support for the family.

The majority of hospice care is provided at home or in a nursing facility. There are also some free-standing hospice facilities and hospice units within hospitals in certain parts of the country.

How do you start hospice care?

To begin hospice care, an individual must have a life expectancy of six months or less. A physician’s referral is needed. If you believe your family member is in need of hospice services, communicate this to the physician currently providing care.

Before hospice care begins, the hospice team meets with the referring physician as well as the family to create an individualized care plan. Once care begins, the family has 24-hour on-call access to hospice staff.

Hospice care can be stopped at any time.

How long can hospice services be received?

Hospice services are usually available for as long as they are needed. If someone receiving hospice care lives beyond six months, services are usually still covered by Medicare, Medicaid and many private insurers as long as a physician recertifies that the person is terminally ill and still meets hospice care requirements. It is best to check with the insurance provider about coverage.

Costs

Hospice is usually covered under Medicare, as well as many Medicaid and private insurance plans.

With Medicare, there are no deductibles and only limited coinsurance payments for hospice services.

Medicare covers hospice care if:

• The person receiving care has Medicare Part A;
• The person’s physician and a hospice medical director certifies terminal illness, that is, life expectancy is six months or less, if the illness runs its normal course; and,
• The person (or person with durable power of attorney) elects to receive hospice care and waives the right for Medicare to pay for any other services to treat the terminal Instead, Medicare pays the hospice and any related physician expenses. Medicare will continue to pay for any services not related to the terminal illness.

In some cases where a person does not have coverage, community donations make services possible.