Tips For Choosing A Hospice Care Provider
Hospice is an incredible service provided at any desired, qualified location – hospital, nursing home, assisted living community, the comfort of your own home, a dedicated hospice house, etc. While the medical and comfort services offered by hospice care providers are fairly universal from agency to agency, the accompanying services may vary.
Basic hospice services include:
- A case physician who admits the client to hospice and continues checking in and communicating with nurses on a regular basis
- Delivery and set-up of durable medical equipment ranging from hospital-style beds and side tables to oxygen, walkers, and bedside commodes
- Hospice nurses (R.N.)s are the front line of hospice care, making the majority of the decisions and visiting clients weekly, or multiple times a week, depending on where the client is on their journey and the types of care required
- On-call nurse support, 24/7
- Prescription drugs and other equipment necessary to facilitate medical care and comfort
- Home health aids (often CNAs, but not always) come in regularly to support the client with hygiene care such as bathing, getting into fresh clothes, changing linens.
- Respite care of some kind, typically via volunteers, to give primary partner/spouse/family caregivers some time off once a week or so
- Some level of grief support (bereavement care)
- Spiritual care, support, direction (for the client and family) offered by hospice chaplains
Things To Think About When Choosing A Hospice Care Provider
Here are some of the things to consider and discuss with your family before choosing a hospice provider.Is the client choosing to die at home?
If you are the primary caregiver and/or the client is choosing to die at home, the adjunct services offered by hospice may be more important to you – especially if your loved one will be on hospice service for a matter of months, rather than days or hours. Unlike clients who are signed up for hospice in a hospital, assisted living, or designated hospice houses (where care staff, meals, and other services are already a part of the service offerings), families of clients who die at home will want to find an agency who can support the big-picture needs.Who is covered by your personal health insurance plan?
Hospice is typically picked up by Medicare but is also covered by personal healthcare insurance whenever possible. Where you live will certainly determine prospective hospice care providers because most travel within a certain territory. Your health insurance provider may also have “preferred providers,” with whom they’ve already established “favorable rates.” It is worth checking in with those hospice agencies first and expanding your search from there if you don’t find a good fit.Do they have additional accreditation(s)?
All hospice care agencies are heavily regulated by the federal government because of the associated Medicare/Medicaid. However, many go the extra mile to gain additional accreditations with reputable agencies such as the Joint Commission and the Community Health Accreditation Program (CHAP) to further exemplify their excellent quality of service.Which extra support services are most needed from your hospice care provider?
Hospice agencies rely on volunteer support, and the more volunteers there are, the more rich the service offerings can be above and beyond the “basic hospice care” services we listed in the introduction. The following is a list of services that may or may not be offered by volunteers and hospice staff. Jot down the services your family finds most valuable or needs most, and then look for hospice care agencies that accommodate those:- Bilingual care or care in the client’s native language
- Respite care (having someone come sit with the client while the primary caregiver(s) take some time off) is typically available on a weekly basis or bi-monthly basis.
- Grocery shopping or general errand running
- Companion services (to have someone come to read, play games or cards, listen to/tell stories, conversation, watch TV together, etc. – tailored to the interests of the client
- Light housekeeping
- Meal preparation
- Gardening
- Pet walking/care
- Singing
- Plant watering
Conduct Interviews With At Least Three Agencies
The more agencies you interview, the better feeling you will have for their company culture and service offerings. Even if the services are more or less the same, there is a good chance the client and family will have stronger connections with one over another, and this connection is important when beginning the journey you will all be on together.Ask Questions To Help You Learn More About Your Prospective Hospice Care Provider
This is a challenging time, and it can be hard to think straight and remain in “business mode” with all that you are handling on the emotional and energetic spectrum. These questions can help guide your “interviews” with prospective hospice care providers. Asking the same questions helps you to compare “apples-to-apples” so to speak. Request permission to use your smartphone to record the interviews, which allows you to play them back and re-listen when you have a moment to be focused or take good notes about the experience to reflect on later when making your final decision. These questions are courtesy of the Hospice Foundation of America.- What is the typical response time if we need to reach someone at the hospice after normal business hours, or on weekends and holidays?
- How quickly will a plan of care be developed for the individual by the hospice?
- How quickly can we expect pain and/or symptoms to be managed?
- How quickly will the hospice respond if medications do not seem to be sufficiently addressing pain or symptoms?
- What does the hospice do when someone’s pain cannot be adequately managed at home?
- If there is a need for inpatient care, how will that be addressed by the hospice?
- Are there any services, medications, or equipment that the hospice doesn’t provide?
- What kind of out-of-pocket expenses should the family anticipate?
- How often will a hospice team member visit and how long will most visits last?
- When the hospice orders medication, where can it be picked up, or is it delivered by the hospice?
- Do members of the team providing care have additional training and certifications for their hospice and palliative care skills?
- What is expected of the family caregiver?
- Will the hospice provide training to family caregivers?
- Can the hospice provide respite care to give family caregivers a break and how does the hospice arrange that?
- What help do your hospice volunteers provide and how can we request help from a volunteer?
- Does the hospice measure quality of care and does it have any quality data it can share?
- What kind of bereavement support is offered by the hospice?
- If we are unhappy with some aspect of care the hospice is providing, who can we contact at the hospice?
- We recommend printing the questions – and any others the client, primary caregivers, or family members have to direct the interview process.