Where Can I Receive Hospice Care? Home-Based vs. In-Patient Care

undefinedHospice provides comprehensive, compassionate services to patients at the end of life in the most comfortable environment possible. It’s important to remember that hospice care is a philosophy, not a place. Services can be provided in a variety of settings based on the patient’s wishes and needs. In most, hospice is provided in the comfort of a patient’s home. Depending on the patient’s condition, these same services can also be provided in long-term care facilities, nursing homes, hospitals, and Medicare-approved hospice facilities.

Home-Based Care

Hospice was founded on the concepts of enhancing quality of life for patients and families. For most patients, this means remaining at home with loved ones. After an initial home visit, a hospice team prepares a comprehensive, individualized care plan. The care team includes a range of specialists, from a physician, nurse and home health aide to a social worker, chaplain and volunteer, who are specially trained to address a range of physical, emotional and spiritual needs. The hospice team may also recommend specific medical equipment at home, which is covered by the Medicare Hospice Benefit. Ongoing assessments are also conducted to keep the patient’s care plan up to date with medications, therapies, and equipment needed.

Types of In-Patient Care

There are some patients with complex symptoms or issues who may not be cared for at home. Examples of these might be if:

  • The patient has no family members involved in his/her care.

  • The patient cannot be safely cared for at home.

  • The patient has complex needs that require supervision in a more structured medical facility.

You may receive care in a variety of settings depending on your medical needs, from long-term care facilities to designated units of hospitals and free-standing hospice facilities.

  • Long-Term Care Facilities: Hospice care can be provided in addition to the standard care a patient is receiving in an assisted living or nursing facility. An outside hospice team provides specialized services that address a patient’s needs at the end of life, while continuing to receive care from the staff of the facility in which they reside.

  • In-Patient Units: There are some hospitals that have in-patient hospice units to provide acute care for patients who are experiencing distressing symptoms that cannot be managed at home or in a nursing home. The patient may receive hospice care from a team of specialists at the hospital, or from an outside hospice provider. Often the goal of in-patient hospice units is to address acute symptoms, so the patient may return to his/her home or facility.

  • Hospice Houses: Some hospice providers have freestanding units that provide a homelike atmosphere to patients. Typically referred to as “hospice houses,” these places of care are designed for short stays and are options when the patient requires care around-the-clock.

Making the decision to receive hospice services is a process that requires ongoing collaboration among the patient and family, physician, hospice provider, and sometimes the patient’s facility. If a patient is hospitalized when the decision to receive hospice is made, the hospital discharge planner should help the patient and family make the appropriate considerations in choosing a hospice provider. Whether hospice services are provided at home or in a facility, the primary goal is to keep patients comfortable and pain-free.

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