How to Choose a Hospice - The RIGHT Questions to Ask

Hospice care can be a hot button issue. You’ve probably seen mixed reviews on the right hospice care, when to do it and the implications of a patient entering hospice care. It can be hard to tell the difference between accurate information and information that might be biased or poorly researched. In fact, Consumer Reports recently published an article, How to Find a Good Hospice Program, that featured six tips for finding the right hospice care that appear to be one-sided, and leaning toward a specific type of hospice: non-profit with inpatient care.

Crossroads Hospice doesn’t fit the description from Consumer Reports, and really doesn’t want to. The description leaves out the important nuances of hospice care; the services that make hospice care the best it can be for the patient and the family.

Perry Farmer, Founder and CEO of Crossroads Hospice, captured Crossroads’ stance perfectly on the piece. “Consumer Reports has been a trusted source of information for many Americans, but, the How to Find a Good Hospice article misses the mark on the core components of hospice care,” he says.

“It’d be like if the article was about cars, and instead of including information on price, gas mileage, maintenance, safety, etc., the article advises consumers to buy their cars on the basis of the company’s tax status.”

Perry continues, “When it comes to hospice, Consumer Reports should point health care decision makers and consumers toward time spent with patients, staffing ratios, attended deaths, symptom control, spiritual and emotional support, an outstanding bereavement program, State and Federal deficiencies report and add-ons to care.”

The following are Consumer Reports’ six factors in choosing a hospice, and Crossroads Hospice’s views on them:

1. "Not-for-profit status and 20 or more years of experience.”

Tax status is not the determining factor in patient care. Consumers should know all hospices are paid the same rate for the various levels of care, but each agency spends its financial resources in different ways. More important is whether the hospice is well-managed. Some key questions to ask:

• Do they make a commitment to being bedside at the time of or the hours leading up to your loved one’s death?
• Are they staffed 100% with their own employees or do they contract agency staff to provide patient care for daytime and evening hours?

In many cases, a larger hospice will be better able to provide the level of care your family needs due to economies of scale and more experience with a larger patient pool.

2. "Hospice-certified nurses and doctors on staff and available 24 hours per day."

This is a great point. In fact, staff should be available to come to your home or the assisted living facility where your loved one resides anytime, day or night, when you call with an urgent need. Ask hospice companies that you are considering these questions:

• What is their response time?
• Do they have a dedicated on-call team ready to respond to your family’s 2:00 am needs? Or, do they have a daytime staff that must also cover evening hours?

3. "Palliative-care consultants who can begin care if you’re not yet ready for hospice."

Let’s get this straight: palliative care and hospice care are not the same thing. Palliative care is a growing field that offers symptom management and relief from pain for any serious illness. A quality hospice should be able to provide consultation on the care you currently require and advise you on the care you'll need in the future.

4. "An inpatient unit, where patients can go if symptoms can’t be managed at home."

5. "Ability to provide care in nursing homes and assisted living residences."

Both these points are valid, but forget to include the most important part: the patient’s wishes. Most patients under hospice care can receive the needed care at all stages of the dying process in the place of their choosing. You can ask a hospice if they have general in-patient beds available, but the focus should always be on the wishes of the patient. If they wish to remain at home, that desire should be honored if medically possible.

6. "Medicare approval. That way, Medicare will cover services, including equipment and home health aides as needed, plus counseling and grief support for the patient and the family."

Most hospices are certified by Medicare, including Crossroads Hospice. Medicare covers people over the age of 65 and those with certain disabilities. If you or your loved one is covered by Medicare, the government will pay 100 percent of your hospice fees with no deductibles and no copays. About 90 percent of hospice patients are Medicare beneficiaries, and more than 1.5 million Americans received hospice care last year.

Other Factors to Consider When Choosing Hospice

There are other factors not mentioned by Consumer Reports that you should consider when making your decision. Below are a few more key questions to ask your hospice to make sure you’re choosing the right care for your loved one and your family:

• Will the hospice be with the patient in their final moments?

No one should die alone. The Consumer Reports article doesn’t consider the care and service a patient gets at a key moment in their life – the end. While the national average for attended deaths hovers around 20 percent for most hospice providers, Crossroads Hospice offers the Evenmore Care program, and our attended death average at all of our locations is above 80 percent. We do everything we can to ensure no one dies alone.

• What is the average number of visits the hospice will provide each week?

Crossroads Hospice averages five visits per week. Medicare only requires one visit every 14 days, but your family member may require more support. Our visits include various disciplines within their care team including aides, nurses, social workers, chaplains, volunteers and bereavement support.

• How long is the admissions process?

Hospice admission needs to be a quick and efficient. A few questions to ask your hospice include:

1. Can the hospice meet with you the same day the hospice recommendation is made by a physician?
2. Can a patient be admitted to the hospice at night, on weekends, or on a holiday?
3. If they can't meet with you after hours, will your loved one receive care after business hours if needed?

If you have a question or need to be admitted to hospice, Crossroads Hospice is available 24 hours a day, seven days a week, 365 days a year.

• Does the hospice offer special programs to meet the needs of military Veterans?

Veterans require emotional support that differs from that of civilians. If your loved one is a Veteran, it’s important to select a hospice with the necessary experience. Specifically, partners in the We Honor Veterans program have proven a commitment to this type of care. Crossroads Hospice offers Veteran care, plus our Veteran Recognition program.

More Information

Your town may have anywhere from five to 150 different hospice companies to choose from and while this may seem like an overwhelming number, remember to focus on what is most important to your family. That will help narrow the field.

If you have additional questions about hospice, we’re available at all times to speak with you. Contact Crossroads Hospice now online or by phone at 1-888-564-3405.

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