Preguntas frecuentes sobre hospicio
FAQs about Hospice Services
- ¿Qué es hospicio?
- What does it mean when it’s time to call hospice?
- What’s the first step to getting started with hospice care?
- ¿Quiénes integran el equipo de hospicio? Who is responsible for care?
- Where do patients receive hospice services?
- ¿Cuáles son los "tipos de cuidados" del hospicio?
- If hospice is for the dying, does choosing a hospice mean giving up on my loved one?
- When is it time for hospice?
- What is the difference between diagnosis and prognosis?
- ¿Hay algún signo de que un paciente puede estar listo para los servicios de hospicio?
- What are the qualifications for hospice care?
- ¿Con qué frecuencia el enfermero o médico de hospicio visitan al paciente?
- Can my doctor still be my doctor if I go on hospice?
- Will our family still have a say about our mother’s care if she’s on hospice?
- What if the hospice patient has special needs?
- What if my family member needs special equipment?
- Who will talk to me about my loved one once we have hospice? Who will keep us informed?
- If I have home health, why do I need hospice care?
- My mother is already in a nursing home. Why would she need hospice services there?
- Why would I put my child in hospice? Isn't hospice for the very old?
- Will hospice care for my dad 24/7? Will I still need to take care of him?
- What is end-of-life care?
- What is “comfort care?”
- What is palliative care?
- What is respite care?
- I don't want my wife to die in our home. Can we have inpatient care instead?
- Can you come to talk to my sister about hospice but not mention cancer, death or dying? She doesn't know.
- What if a patient’s health improves while on hospice care?
- What is an advance directive?
- What happens after my loved one dies?
- ¿El hospicio se encarga del duelo y otras emociones?
FAQs about Paying for Hospice
- ¿Quién se encarga de pagar el hospicio? Is it covered by my insurance? ¿Medicare? ¿Medicaid?
- Who pays for hospice room and board?
- If I don’t have insurance, can I still receive hospice services?
- If Medicare covers my hospice services, will I lose my other Medicare coverage?
- Can I have hospice and also keep my HMO?
- Is there a fee for a hospice consultation?
FAQs about Hospice and Medical Conditions
- What are the signs that hospice is right for heart disease patients?
- What are the signs that hospice is right for Alzheimer’s and dementia patients?
- ¿Por qué un paciente con Alzheimer recibiría cuidados de hospicio?
- What are the signs that hospice is right for ALS patients?
- What are the signs that hospice is right for cancer patients?
- ¿Un paciente puede recibir quimioterapia y servicios de hospicio al mismo tiempo?
- What are the signs that hospice is right for COPD patients?
- What are the signs that hospice is right for Parkinson’s Disease patients?
FAQs about VITAS Healthcare
- ¿Quién es VITAS Healthcare?
- ¿Dónde se encuentra VITAS?
- ¿Qué tipo de servicios ofrece VITAS?
- ¿Cómo comienzan los servicios de VITAS?
- ¿Qué es Asociados de Cuidados Paliativos?
- Why should I choose VITAS?
FAQs about Hospice Services
¿Qué es hospicio?
Hospice is a way to care for people who are terminally ill by focusing on pain relief and symptom management, as well as emotional and spiritual end-of-life issues, instead of trying to cure the disease.
Más información: Servicios de hospicio de VITAS
What does it mean when it’s time to call hospice?
Calling hospice means deciding that the patient and family no longer want to pursue curative care. Generally, a physician determines that a patient's life expectancy is six months or less; most medical treatments and interventions are no longer effective, will not cure the disease and/or will prolong suffering. Calling hospice takes a patient's care away from disease specialists and surgeons and gives it to an interdisciplinary team trained in comfort care, pain relief, psychosocial support and quality of life at the end of life.
What’s the first step to getting started with hospice care?
Anyone can request a hospice evaluation at no cost. Sometimes the physician makes the referral or provides several options and lets the patient/family decide. The physician must certify to the hospice provider that the patient is eligible and has a prognosis of 6 months or less. When a referral is made, the hospice provider makes an appointment (the same day or on a date convenient for the family) to meet with the patient and family. The admissions nurse evaluates the patient, answers the family's questions and creates a plan of care that reflects the patient/family's wishes. If the discussion goes well and the family is ready to decide, they sign admissions paperwork and the hospice team begins to visit.
¿Quiénes integran el equipo de hospicio? Who is responsible for care?
Hospice patients receive services from an "interdisciplinary" team, meaning members come from different disciplines or fields. They may include a physician, registered nurse, hospice aide, social worker, chaplain, bereavement services manager, volunteer and other healthcare professionals.
A full range of services: The VITAS Care Team
Where do patients receive hospice services?
Los servicios de hospicio generalmente se prestan en el hogar del paciente, que puede ser una residencia privada, comunidad de vida asistida u hogar de ancianos. Patients can also receive hospice services while in the hospital, or in an inpatient hospice unit.
Hospice is not a place: Cuidado de hospicio a domicilio
¿Cuáles son los "tipos de cuidados" del hospicio?
Levels of care are specific types of hospice care to address different needs of patients and families. Medicare exige que todos los proveedores de hospicio ofrezcan four distinct levels of care. They are:
- Routine hospice care in the home
- Turnos de control de síntomas agudos en el hogar cuando sea médicamente necesario. VITAS calls this Intensive Comfort Care®, it can also be called “cuidado continuo.”
- Round-the-clock inpatient care when symptoms cannot be managed at home
- Respite inpatient care for the patient when the family caregiver is away 1−5 days
If hospice is for dying, does choosing a hospice mean giving up on my loved one?
No. When treatment options for a disease have been exhausted or no longer work, hospice provides a way for people to live in comfort, peace and dignity without curative care. Hospice isn't about giving up, but about improving the quality of the patient's life by being free of pain, surrounded by family and in the comfort of home.
Focusing on the person, not the disease: Hospice is Not About Giving Up
When is it time for hospice?
Patients should consider hospice services when medical treatments can no longer cure their disease and/or symptom burden outweighs the benefits of treatment. Los servicios de hospicio pueden comenzar cuando un médico decide que la expectativa de vida del paciente es de seis meses o menos.
When waiting won't help: El cuidado de hospicio de calidad lleva tiempo
What is the difference between diagnosis and prognosis?
A diagnosis is when the cause of the illness is identified (e.g., the common cold, pneumonia, lung cancer, etc.). A prognosis is a prediction about how the illness will develop. In the case of people who are terminally ill, the prognosis is often the physician's estimate of how long the illness will take to run its course before the patient dies.
¿Hay algún signo de que un paciente puede estar listo para los servicios de hospicio?
Cuando la carga del tratamiento supera los beneficios y/o el paciente ha sido hospitalizado varias veces en los últimos meses, es posible que esté listo para el hospicio. Otros indicios incluyen:
- Varias visitas al departamento de emergencias
- Dolor crónico
- Infecciones frecuentes
- Deterioro repentino o progresivo en el funcionamiento físico y alimentación
- Pérdida de peso/dificultad para tragar
- Insuficiencia respiratoria/dependencia a oxígeno
What are the qualifications for hospice care?
A patient is eligible to receive hospice services when their illness is terminal, meaning a physician has determined that they could die within six months if the disease continues as expected. There are medical guidelines that accord with the patient’s disease and help a physician make a hospice referral.
¿Con qué frecuencia el enfermero o médico de hospicio visitan al paciente?
The hospice nurse creates a plan of care with the patient's and family's input, designed to meet the patient's needs. En este plan se determina la frecuencia de las visitas del médico, enfermero y otros integrantes del equipo de hospicio.
Can my doctor still be my doctor if I go on hospice?
Yes. Hospice physicians and team members work with your doctor to ensure your clinical and emotional needs are being met and that your care is being carried out appropriately. Your doctor chooses his or her level of participation in your care.
Will our family still have a say about our mother’s care if she’s on hospice?
Yes. Family input is important and is the driving force behind developing the most effective plan of care for your mother.
Descarga gratis: Guía para hablar en familia sobre el hospicio
What if the hospice patient has special needs?
El plan de cuidados de hospicio se desarrolla según las necesidades del paciente. If special equipment (e.g., wheelchair, lift, trapeze bar, etc.) or therapies (e.g., respiratory therapy, physical therapy, etc.) are needed, the hospice provider offers these as part of its services. Perhaps the need is for a certain religious practice or person, a family or cultural tradition, a language other than English or another unique circumstance. Hospice providers address each patient's needs.
What if my family member needs special equipment?
Hospice patients may need oxygen, a special lift for over the bed, a bedside commode, incontinence supplies or medications that are related to their terminal disease. Sometimes a hospital bed or Geri chair makes it easier for the family caregiver to attend to the patient at home. Medications, supplies and "durable medical equipment" are part of the hospice team's plan of care for the patient, and should be provided at no cost by the hospice. Because the family is part of the hospice team, they should be included in discussions of the plan of care and what the hospice patient needs to be comfortable.
Continue Reading: Equipos médicos a domicilio de VITAS
Who will talk to me about my loved one once we have hospice? Who will keep us informed?
You will always be kept up-to-date on your loved one's condition. The primary hospice nurse can answer any questions you have, tell you about your loved one's care and progress, and prepare you for what to expect.
Considering all perspectives: Qué esperar en los primeros días de hospicio
If I have home health, why do I need hospice care?
Hospice offers many servicios home health care does not, such as prescriptions, equipos médicos and visits from an interdisciplinary healthcare staff. Typically, the goal of home healthcare is to help the patient become more independent, and visits decrease in frequency as the patient's condition improves. El objetivo del hospicio es mantener al paciente confortable a medida que los síntomas empeoran. Los servicios de hospicio cambian para adaptarse a las necesidades del paciente.
What's the Difference? Home Health Care or Hospice Care
My mother is already in a nursing home. Why would she need hospice services there?
Los hogares de ancianos se enfocan en el cuidado diario de rutina y rehabilitación. Nursing home residents who receive hospice services get additional, customized support determined by their plan of care, which focuses on the physical, emotional and spiritual end-of-life needs of patients and their families.
Why would I put my child in hospice? Isn't hospice for the very old?
El hospicio es para cualquier persona con una enfermedad terminal. Desde bebés hasta adultos y ancianos, el hospicio ofrece calidad de vida cerca del final de la vida y apoyo para aquellos que cuidan al paciente.
Leer más: ¿Qué es el cuidado de hospicio pediátrico?
Will hospice care for my dad 24/7? Will I still need to take care of him?
Yes, you will always be his primary caregiver. Hospice can supplement that care to help share the responsibility of caregiving with regular visits and education from the hospice care team.
Here to help: El hospicio es una amplia variedad de atención
What is end-of-life care?
Care near the end of life focuses on comfort rather than cure. It is care that accepts that the patient is declining and that attempts to reverse the course of their terminal illness would be futile or that side effects would outweigh any benefit. The patient is terminally ill and chooses comfort care, which is also known as cuidado paliativo.
Leer más: End-of-Life Care Resources
What is “comfort care?"
Comfort care focuses on comfort and relief from symptoms as opposed to curing or treating the disease. Comfort care addresses all the needs of the patient and family-physical, emotional and spiritual.
What is palliative care?
Palliative care is supportive care that provides relief from the symptoms, physical stress and mental stress of a serious or life-limiting illness at any stage of the illness, and it can be provided concurrently with curative therapies and treatments. Palliative medicine specialists control pain, manage symptoms, assist with difficult medical decisions about various treatments, coordinate care with other healthcare professionals, and craft a care plan based on the patient's wishes and preferences. Palliative care can be provided at home or in other settings, including hospitals and skilled nursing facilities. A palliative care team may include the patient and caregiver(s), a doctor, nurse, pharmacist, dietitian, physical or occupational therapist, social worker, chaplain and other healthcare professionals as needed.
What is respite care?
Respite care (pronounced RESS-pit) gives a break, or "respite," to family members and caregivers who are caring for a loved one receiving hospice services. A daughter who cares for a mother with Alzheimer's disease, for example, might need a few days off to travel, attend to other family members or take a break from the 24/7 stress of caregiving. Hospice respite care is mandated by the Medicare hospice benefit for any beneficiary whose caregiver needs a break of up to five consecutive days and nights. It places a hospice patient in a facility that provides 24-hour care (e.g., nursing home, skilled nursing facility, hospital or hospice unit) without having to meet the criteria for traditional inpatient care or symptom management.
I don't want my wife to die in our home. Can she have inpatient care instead?
Your preference for inpatient care should be discussed with the hospice representative who evaluates your wife or with the hospice team if she is already a hospice patient. Cada paciente y cada situación es diferente.
Can you come to talk to my sister about hospice but not mention cancer, death or dying? She doesn't know.
Hospice professionals are specially trained to discuss sensitive matters with patients and their loved ones. Usually, a hospice representative will begin the conversation by asking the patient what the doctor has said and what the patient understands about his or her condition. The answer to these questions will determine the words the representative will use.
What if a patient’s health improves while on hospice care?
Patients often improve with hospice services, because the focus of their care shifts to comfort, pain relief, symptom management and quality of life. They still have a terminal illness, but their symptoms are so improved that they no longer qualify for hospice services. A hospice must discharge a patient whose underlying disease or condition is no longer considered terminal. Patients can revoke hospice care for any reason at any time. Patients can also return to hospice at any time, as long as their doctor re-certifies their eligibility.
What is an advance directive?
An advance directive is a legal document that lets you direct in advance the care you will receive at some future time. It is often important near the end of life, when many people are not able to speak for themselves. Completing an advance directive requires that you consider your options and make decisions now, while you are healthy, about what you do and do not want if you are seriously ill and unlikely to get better. Advance directives include different forms and vary by state. They may be called Power of Attorney for Healthcare, Living Will, Five Wishes, Medical Power of Attorney, Healthcare Proxy, My Directives, Advance Care Planning, etc.
Continue Reading: Directivas anticipadas: lo que debe saber
What happens after my loved one dies?
Ideally, a member of your hospice team will be at the bedside at the time of death, able to explain the stages of death, make necessary phone calls, prepare the body and support the family in the first few hours. He or she will arrange for the body to be removed or, if the family would like to wait, perhaps until a family member arrives, that can be arranged as well. If a member of the team is not present at the death, he or she will arrive as soon as you call the hospice provider.
What to expect: ¿Qué sucede cuando un paciente de hospicio muere en casa?
¿El hospicio se encarga del duelo y otras emociones?
Hospices employ bereavement specialists to address all aspects of dolor, including duelo anticipado y la grief process after death. Hospices provide servicios de apoyo ante el duelo for the family for up to 13 months after the death.
Grief is normal: Grief and Grieving - VITAS Provides Support After a Death
FAQs about Paying for Hospice
¿Quién se encarga de pagar el hospicio? Is it covered by my insurance? ¿Medicare? ¿Medicaid?
La Parte A de Medicare cubre el 100% de los servicios de hospicio. En general, la mayoría de hospicios también trabaja con Medicaid, el Departamento de Asuntos de los Veteranos y aseguradoras privadas.
How payment works: Medicare y el costo del cuidado de hospicio
Who pays for hospice room and board?
There is no room-and-board fee for hospice services. Hospice is brought to the patient in the place they call home-an apartment, nursing home, assisted living community or other residential care facility. Even when a patient is placed in a freestanding hospice facility, there is no room and board fee. And while 98 percent of hospice care happens at home*, when hospice patients require round-the-clock inpatient care, that level of care is also provided at no charge to the patient or family. Patients with a terminal illness usually pay nothing for hospice services. Medicare, Medicaid and Veterans Health Administration beneficiaries are fully covered. Most private insurances also cover hospice services. Patients with no insurance can be covered by the charitable arm of their hospice provider. Talk to a local hospice provider for more information.
*NHPCO Facts and Figures: Hospice Care in America. Alexandria, VA: National Hospice and Palliative Care Organization, Rev. ed. April 2018, pg 6, “Level of Care.”
If I don’t have insurance, can I still receive hospice services?
Yes. If you don’t have insurance coverage, the hospice admissions staff will work with you to determine financial responsibility and self-payments and to find out if you are eligible for other benefits that could help pay for services.
Covered services: Hospice Patient Eligibility Requirements
If Medicare covers my hospice services, will I lose my other Medicare coverage?
No. If you need hospitalization for any reason unrelated to the terminal disease, traditional Medicare will be used. You can discontinue the Medicare hospice benefit at any time if you want treatment different from what hospice provides. You may also resume the Medicare hospice benefit at any time.
Can I have hospice and also keep my HMO?
Yes. Hospice will provide care related to the primary diagnosis, while the HMO can take care of unrelated healthcare issues.
Is there a fee for a hospice consultation?
Los hospicios no cobran ningún cargo por consultas de elegibilidad.
Get a hospice consultation: Solicite información en línea or call 866.273.0802
FAQs about Hospice and Medical Conditions
Although each of the diseases listed below has unique symptoms, hospice is available to any patient with a prognosis of six months or less. While every patient's case is unique, some symptoms to look for are listed below:
What are the signs that hospice is right for heart disease patients?
- El paciente padece una insuficiencia cardíaca congestiva o una enfermedad coronaria avanzada con episodios frecuentes de angina
- El paciente tiene una anomalía cardíaca por una enfermedad y sufre síntomas notables de fatiga, insuficiencia respiratoria o deterioro funcional
- El paciente ha recibido el tratamiento óptimo para su afección y no es candidato para otra intervención médica o quirúrgica
- El paciente ha recibido el tratamiento óptimo para su afección y ha decidido no recibir un tratamiento especializado avanzado
Continue reading: Cuidado de hospicio para pacientes con cardiopatía
What are the signs that hospice is right for Alzheimer’s and dementia patients?
- El paciente puede decir unas pocas palabras
- El paciente no puede caminar más o levantarse de la cama
- El paciente depende completamente de otros para comer, vestirse y asearse
- El paciente muestra signos de ansiedad severa
- El paciente ha sufrido varios años de deterioro
Continue reading: Cuidado de hospicio para pacientes con demencia y Alzheimer
¿Por qué un paciente con Alzheimer recibiría cuidados de hospicio?
At the end of their lives, Alzheimer's patients present several challenges to their caregivers. When these patients are in the last stages of life, hospice can relieve some of the burden-physically, emotionally and spiritually-for caregivers as well as help the patient's end-of-life experience be comfortable and dignified.
What are the signs that hospice is right for ALS patients?
- Progression* from independent ambulation to wheelchair or bed-bound
- Progression* from normal to barely intelligible or unintelligible speech
- Progression* from normal to pureed diet
- Progression* from independence in most or all activities of daily living (e.g., toileting, feeding, dressing, etc.) to needing major assistance with these tasks
- Negarse a usar sondas para hidratarse y nutrirse y un respirador para respirar
* Progression is defined as the development of severe neurologic disability over a 12-month period.
Continue reading: Cuidado de hospicio para ELA (Enfermedad de Lou Gehrig)
What are the signs that hospice is right for cancer patients?
- El paciente se está debilitando rápidamente y el cáncer está progresando
- El tratamiento no es completamente eficaz
- La carga que el tratamiento ejerce sobre el paciente y su familia es considerablemente mayor que los beneficios
Continue reading: Cuidado de hospicio para pacientes con cáncer
¿Un paciente puede recibir quimioterapia y servicios de hospicio al mismo tiempo?
If the chemotherapy were being used to attempt to cure the cancer, hospice would be inappropriate. However, a patient receiving hospice services may receive chemo for reasons of comfort and quality of life; for example, to shrink a tumor that is pressing on an organ.
What are the signs that hospice is right for COPD patients?
- El paciente ha tenido que acudir al departamento de emergencias una o más veces cada tres meses por una infección o insuficiencia respiratoria
- El paciente pasa la mayor parte de su día en casa
- El paciente ha sido hospitalizado varias veces (es decir, una o más veces en tres meses) y quiere permanecer fuera del hospital
- El paciente ya no quiere que lo intuben
Continue reading: Cuidado de hospicio para pacientes con enfermedad pulmonar
What are the signs that hospice is right for Parkinson’s Disease patients?
- Deterioro funcional continuo
- Estado vegetativo persistente
- Nivel de conciencia seriamente reducido
- Gran dificultad para respirar y/o tragar
- Any of the progressions under “ALS” above
Continue reading: Hospice Care for Neurological Diseases - Stroke, Coma, Parkinson's Disease and Multiple Sclerosis
FAQs about VITAS Healthcare
¿Quién es VITAS Healthcare?
VITAS® (pronounced VEE-tahss) Healthcare is the nation’s leading provider of end-of-life care.
7 more facts: VITAS Healthcare Fast Facts
¿Dónde se encuentra VITAS?
VITAS cares for patients and families in 15 states and the District of Columbia. Las oficinas centrales de la compañía están en Miami, Florida.
Find us near you: VITAS Healthcare Locations
¿Qué tipo de servicios ofrece VITAS?
- Un equipo interdisciplinario de expertos en hospicio (médico, enfermero, auxiliar de hospicio, trabajador social, capellán y voluntario)
- Un plan de cuidados personalizado
- Four levels of care, including routine care in the home, shifts of acute symptom management in the home when medically necessary (Intensive Comfort Care®), round-the-clock inpatient care when symptoms can’t be managed at home, respite inpatient care
- Telecare®—24/7 support for patients and family and team members ready to be dispatched to the patient’s home after hours if needed
- Medicamentos con receta, medicamentos de venta libre, equipos y suministros médicos
- Terapias holísticas, como musicoterapia y visitas de mascotas a pacientes de hospicio
- Especialista en apoyo ante el duelo por 13 meses después del fallecimiento de un ser querido
Coordinated care: Servicios de cuidado de hospicio de VITAS
¿Cómo comienzan los servicios de VITAS?
El primer paso para comenzar los servicios de VITAS es evaluar al paciente. Para solicitar una evaluación no se necesita la derivación de un médico. Un representante de VITAS habla directamente con el paciente y la familia. Si ellos eligen comenzar con los servicios de hospicio se obtiene la derivación de un médico. El paciente, la familia, el médico y el equipo de VITAS crean un plan de cuidados, que incluye todo lo relacionado con el diagnóstico terminal.
Next step: What to Expect the First Few Days of Hospice
What is Palliative Medical Associates?
The word palliative means comfort. Los cuidados paliativos son cuidados para que el paciente esté cómodo. La intención es tratar el dolor y otros síntomas que causan malestar. Asociados de cuidados paliativos es una división de VITAS Healthcare que ofrece consultas y experiencia en el control de síntomas agresivos y apoyo a los pacientes y familias, independientemente de que el paciente sea elegible para el hospicio o no.
The difference: Cuidado paliativo vs. cuidado de hospicio
Why should I choose VITAS?
At VITAS Healthcare, everyone in the company works from the same belief: patients and families come first. We offer 24-hour support. Our nurses are available at all times, even weekends and holidays. Our patients receive individualized care plans to ensure their needs-physical, emotional, spiritual-and those of their families are always being met.