Here are answers to some of the questions that our patients and families most often ask about hospice. We hope they will help you better understand the hospice concept and how we may support your and your loved ones. If you still have questions that are not addressed here, please call us at (209) 578-6300.

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1. When should a decision about entering a hospice program be made – and who should make it?

At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice. By law the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping an all-out effort to “beat” their disease. Community Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.

2. Should I wait for our physician to raise the possibility of hospice, or should I raise it first?

The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.

3. Can a hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive or life prolonging therapy or go on about his or her daily life.

If a discharged patient should later need to return to hospice care, Medicare, most private insurance and often Medi-Cal will allow additional coverage for this purpose. Even if insurance does not pay for hospice care, we provide care to anyone who needs us, regardless of ability to pay.

4. What does the hospice admission process involve?

One of the first things hospice will do is contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at his time. We also have our own physicians who may take on the role of the attending physician. The patient will also be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.

The so-called “hospice election form” says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign explains how choosing hospice care affects other insurance coverage for the terminal illness. Note: choosing hospice care for terminal illness does not change the coverage patients have for their other healthcare needs.

5. Is there any special equipment or changes I have to make in my home before hospice care begins?

Community Hospice will assess your needs and utilize our Medical Equipment Division to order necessary equipment, deliver and set it up and demonstrate use of the equipment for you. While individual needs may vary, examples of equipment can include hospital beds, wheelchairs and bedside commodes.

In general, we will assist in any way it can to make home care as convenient as possible.

6. How many family members or friends does it take to care for a patient at home?

There's no set number. One of the first things the patient care team will do is prepare an individualized care plan that will, among other things, address the amount of care giving a patient needs. Community Hospice staff visit regularly and are always accessible to answer questions and provide support.

7. Must someone be with the patient at all times?

In the early weeks of care, it's usually not necessary for someone to be with the patient all the time. Later however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone to be there continuously.

While family and friends must be relied on to give most of the care, we do provide volunteers to assist with errands and to provide a break and time away for major caregivers.

8. How difficult is caring for a dying loved one at home?

It's never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. So, our staff is available by phone to consult with the family and to make night visits as appropriate to meet the needs of both the patient and family.

9. What specific assistance does Community Hospice provide home-based patients?

Hospice patients are cared for by our teams of doctors, nurses, social workers, home health aides, chaplains, dieticians and volunteers- and each provides assistance based on his or her area of expertise. In addition, hospices help provide medications, supplies and equipment that are necessary to address the needs related to the terminal diagnosis.

10. Does Community Hospice do anything to make death come sooner?

We do nothing either to speed up or to slow down the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, so our patient care teams provide our presence and specialized knowledge during the dying process.

11. Is the home the only place hospice care can be delivered?

No. Although most hospice services are delivered in a personal residence, some patients live in skilled nursing facilities and assisted living centers.

12. How does hospice “manage pain”?

Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible.

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these, as well. Our social workers and chaplains are available to assist family members as well as patients.

13. What is hospice's success rate in battling pain?

Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.

14. Will medications prevent the patient from being able to talk or know what's happening?

Usually not. It is the goal of hospice to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, hospices have been very successful in reaching this goal.

15. Is Community Hospice affiliated with any religious organization?

Hospice care is not an off-shoot of any religion. While some religious organizations have started hospices (sometimes in connection with their hospitals), Community Hospice serves a broad community and do not advocate any particular belief or require patients to adhere to any particular set of beliefs.

16. Is hospice care covered by insurance?

Hospice coverage is widely available. It is provided by Medicare nationwide, by Medi-Cal and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

17. If the patient is not covered by Medicare or any other health insurance, will Community Hospice still provide care?

The first thing Community Hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, we will provide care for those who cannot pay, using money raised through the Community Hospice Foundation and the generosity of our community.

18. Does Community Hospice provide any help to the family after the patient dies?

We provide continuing contact and support for family and friends for at least a year following the death of a loved one. We also provide bereavement support groups for anyone in the community who has experienced the death of a family member, a friend, or a loved one. To find out more about our bereavement programs, please call the Support Services department at (209) 578-6378.

19. If the patient is eligible for Medicare, will there be any additional expenses to be paid?

Medicare covers all services and supplies related to the terminal illness for the hospice patient.