Eligibility | Payment Options | Hospice House | Counseling Services | Bereavement Services | Consultation Team | Hospice FAQ
1. When should a decision be made about entering a hospice program, and who should make it?
2. Who is eligible for hospice care?
3. Should I wait for our physician to raise the possibility of hospice, or should I raise it first?
4. What is the next step after a physician makes a referral to VNA Hospice?
5. Can a hospice patient who shows signs of recovery be returned to regular treatment?
6. Must someone be with the patient at all times?
7. What assistance does VNA Hospice provide home-based patients?
8. Is caring for the patients at home the only place hospice care can be delivered?
9. How does VNA Hospice manage pain?
10. What is VNA Hospice success rate in battling pain?
11. Will medications prevent the patient from being able to talk or know what’s happening?
12. What are the payment options for hospice care?
13. If the patient is eligible for Medicare, will there be any additional expenses to be paid?
14. Is VNA Hospice only for cancer patients?
15. Will VNA Hospice accept a patient with a feeding tube?
16. Does VNA Hospice provide any help to the family after the patient dies?
17. When is VNA Hospice available to the patient and their family?
18. What if the VNA Hospice patient needs hospitalization?
19. Does VNA Hospice accept patient living in extended care facilities? .
20. What area does VNA Hospice serve?
21. What role does the primary physician play once a patient comes under care?
22. What if a patient under VNA Hospice care lives beyond six months?
23. What is "palliative" care?
25. Does VNA Hospice do anything to make death come sooner?
26. What is the admission criteria?
1. When should a decision be made about entering a hospice program, and who should make it?
At any time during a life-limiting illness, it is 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 the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.
2. Who is eligible for hospice care?
Patients and families are eligible for hospice care as soon as a physician’s prognosis indicates the patient has a life-limiting illness. VNA Hospice programs and services are available to Indian River County residents of all ages with a limited life expectancy resulting from any illness.
3. 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 health care professionals, clergy or friends.
4. What is the next step after a physician makes a referral to VNA Hospice?
Our admissions coordinator will call to set up an appointment with the patient, the patient's caregiver (usually a designated family member) and other family members. A VNA Hospice admissions nurse will then visit the patient where they are residing, or in the hospital, and complete a detailed physical assessment of the patient's condition. Our interdisciplinary services are described, questions are addressed and the patient can choose to come under VNA Hospice care at that time. One of the patient's caregivers must attend the initial assessment, which can be scheduled after business hours and on weekends. Family members are encouraged to be present.
5. Can a hospice patient who shows signs of recovery be returned to regular treatment?
If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from VNA Hospice and return to aggressive therapy or go on about their daily life. If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
6. 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, VNA Hospice generally recommends someone be there continuously.
7. What assistance does VNA Hospice provide home-based patients?
VNA Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, home health aides, clergy, therapists and volunteers. In addition, VNA Hospice helps provide medications, supplies, equipment, hospital services and additional helpers in the home, if and when needed.
8. Is caring for the patients at home the only place hospice care can be delivered?
No. Although 90 percent of hospice patient time is spent in a personal residence, some patients live in nursing homes, assisted living facilities or the VNA Hospice House.
9. How does VNA Hospice manage pain?
VNA Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain, and it addresses each. 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, and they are often joined by specialists trained in music therapy, art therapy, massage and diet counseling.
10. What is VNA Hospice success rate in battling pain?
Very high. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.
11. Will medications prevent the patient from being able to talk or know what’s happening?
Usually not. It is the goal of hospice to allow the patient to be pain-free, but alert. By constantly consulting with the patient, VNA Hospice has been very successful in reaching this goal.
12. What are the payment options for hospice care?
Hospice care is reimbursed by Medicare and Medicaid, most private insurance policies, preferred provider organizations (PPOs) and other types of funding. Coverage is available as a benefit under Part A to individuals who elect to receive non-curative care and services for their life-limiting illness by waiving the standard Medicare and Medicaid benefits for traditional treatment of the illness. However, patients may continue to access standard Medicare and Medicaid benefits for treatment of conditions unrelated to the hospice diagnosis.
13. If the patient is eligible for Medicare, will there be any additional expenses to be paid?
The Hospice-specific benefit under Medicare and Medicaid provides comprehensive coverage for services that relate to the patient’s life-limiting illness and are outlined in the patient’s plan of care when they enter the VNA Hospice program. This includes medication, nutritional supplements, medical supplies and equipment, and counseling services for patients and families, as well as the services of physicians, nurses, social workers, home health aides, therapists, bereavement specialists and chaplains. At the Hospice House, there is a room and board fee that is assessed to the patient that is not covered by Medicare and Medicaid. The fee is determined when a patient enters the Hospice House.
14. Is VNA Hospice only for cancer patients?
No, more than one-fifth of hospice patients nationwide have diagnoses other than cancer. Increasingly, hospices are also serving families coping with the end stages of chronic diseases, like emphysema, Alzheimer’s, heart and neuromuscular diseases.
15. Will VNA Hospice accept a patient with a feeding tube?
Yes. Patients and families are eligible for hospice care as soon as a physician’s prognosis indicates the patient has a life-limiting illness, regardless if a patient has a feeding tube. VNA Hospice staff provides support and guidance to patients and their families regarding treatment options and end-of-life decisions.
16. Does VNA Hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. VNA Hospice also offers bereavement groups and support for anyone in the community who experienced a death of a family member, friend or co-worker.
17. When is VNA Hospice available to the patient and their family?
VNA Hospice offers 24 hour a day, seven days a week on-call availability for emergencies. To reach VNA Hospice any time, you may call (772) 978-5600.
18. what if the VNA Hospice patient needs hospitalization?
If hospitalization is needed, the VNA Hospice interdisciplinary treatment team will coordinate the transition and maintain contact with the patient and their family during the patient's stay in the hospital. VNA Hospice has contracts with all hospitals in our service area.
19. Does VNA Hospice accept patient living in extended care facilities?
VNA Hospice provides care in skilled nursing homes, assisted living residences and retirement communities. VNA Hospice also provides consultation on pain and symptom management as well as ongoing training/education on patient care, family needs and grief and loss information and support to facility staff.
20. What area does VNA Hospice serve?
VNA Hospice serves all of Indian River County, Florida.
21. What role does the primary physician play once a patient comes under care?
The primary/referring physician is a part of the VNA Hospice interdisciplinary treatment team. Team members update and consult with the physician on a regular basis.
22. What if a patient under VNA Hospice care lives beyond six months?
If the patient's disease follows its normal course, without curative treatment, the life expectancy is usually six months or less. However, patients will not be discharged from VNA Hospice care if they exceed that time frame, as long as they meet the criteria for receiving hospice care.
23. What is "palliative" care?
Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Palliative care is interdisciplinary, team-based care that helps alleviate pain and symptoms to improve quality of life. Palliative care enhances an individual's overall well being by addressing physical, emotional, social and spiritual needs during a life-limiting or life-challenging illness. Palliative care can be used to help people from the point of diagnosis of serious or chronic disease, even as effort to cure continue.
24. Why is it more beneficial to come under VNA Hospice care early in the disease process?
Hospice is a holistic approach to end-of-life care, in the home or home-like setting, addressing the physical, emotional, psychosocial and spiritual needs of the patient and family. It is important to have adequate time for the interdisciplinary care team to establish a rapport with the patient/family so that goals can be accomplished and care giving relationships and trust life care with your physician.
25. Does VNA Hospice do anything to make death come sooner?
No. VNA Hospice does nothing to either speed up or slow down the dying process, but recognizes that death is a natural part of life. Just as doctors and midwives lend support and expertise during the time of childbirth, VNA Hospice provides its presence and specialized knowledge during the dying process.
26. What is the admission criteria?
In order to be admitted to the Hospice House, each patient will need to meet the following criteria:
- confirmed diagnosis of a terminal illness
- lack of available caregiver
- care needs exceeding the caregiver's abilities
