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When is it Time for Hospice?
It can be difficult for patients and their families to know when it’s time for hospice. However, medical studies show that patients who choose hospice as early as possible for a terminal illness tend to live better and longer lives than those who wait.
If four or more of these apply, hospice may be the best answer.
- Physician has given a limited life expectancy (six months or less).
- Several hospitalizations or visits to the emergency room over last six months.
- Increased medication for physical pain.
- Several falls within the last six months.
- Frequent phone calls to physician’s office.
- Majority of day spent in bed or chair.
- Require assistance with two or more of the following: getting out bed, bathing, dressing.
- Noticeable shortness of breath, even at rest.
- Feeling more tired and weaker overall.
- Dramatic weight loss, clothes noticeably looser.
Starting hospice isn’t an easy decision. Speak with your physician, family members and trusted loved ones, and call us at (808) 550-2552 to discuss your options.
How Do I Start Hospice Service?
Patients can be referred to hospice by a physician, family member or loved one, or can choose to refer themselves. However, a patient’s physician will need to provide a medical referral before services begin.
Step 1: Call Islands Hospice (808) 550-2552.
We will collect basic information by phone and contact the patient's physician for a medical referral.
Step 2: Community liaison visit.
Our community liaison will visit with the patient and family to:
- Answer any questions or concerns the family may have
- Explain the role of the Islands Hospice Care Team in the comfort care setting
- Provide an overview of insurance coverage specific to the patient
- Obtain signatures on release and consent forms
Step 3: Assessment and admission.
Our admission nurse will meet with the patient and family to:
- Provide an assessment (physical and current medications)
- Review symptoms
- Arrange for medical equipment for the patient
- Formally admit the patient onto Islands Hospice Service
Please call us at (808) 550-2552 to find out if hospice care would be appropriate for you or your loved one.
How Long is Hospice Care Available?
Many believe that signing up for hospice care is a sure sign of imminent passing, but in fact the course of a fatal illness may run for months.
At Islands Hospice, our focus is not on when life ends, but the quality of life for the time that remains. That means doing all we can to provide the best care available for our patients, ensuring their comfort and giving peace of mind to family and loved ones. And while it’s true no one can predict the length of life’s journey, Islands Hospice is committed to being there with you and your loved ones while preserving the dignity of a life rich with meaning.
How Much Does Hospice Cost?
With healthcare costs rising, many of our patients and their families wonder how they’ll pay for end-of-life care. You can rest easy knowing that Islands Hospice does not charge any fees to our patients or their families for our services.
Medicare and Medicaid cover 100 percent of the benefits of hospice care, and most insurance plans provide coverage. Islands Hospice provides full hospice service regardless of your ability to pay. If you have further questions regarding insurance please contact your carrier and ask specifically about hospice coverage or call Islands Hospice at (808) 550-2552 and ask to speak to our intake department.
Do I Have to Leave My Home?
Hospice is a service, not a place. This means you DO NOT have to leave your place of residence or relocate a loved one to a new environment. Islands Hospice is committed to helping patients live out the final moments of their lives in the place they call home.
We collaborate with individuals and families to create a specific care plan to keep our patients in the comfort and security of their homes.
What Are the Myths and Realities of Hospice Care?
Myth: Hospice is a place.
Reality: Hospice is a service and philosophy of care, not a specific place. Hospice care usually takes place in the comfort of an individual’s home, but can be provided in any environment in which a person lives, including a nursing home, assisted living facility, or residential care facility.
Myth: Hospice means that the patient will soon die.
Reality: Receiving hospice care does not mean giving up hope or that death is imminent. The earlier an individual receives hospice care, the more opportunity there is to stabilize a patient’s medical condition and address other needs.
Myth: Hospice is only for cancer patients.
Reality: A large number of hospice patients have congestive heart failure, Alzheimer’s disease or dementia, chronic lung disease, or other conditions.
Myth: All hospice programs are the same.
Reality: All licensed hospice programs must provide certain services, but the range of support services and programs may differ. In addition, hospice programs and operating styles may vary from hospice to hospice.
Myth: Hospice is just for the patient.
Reality: Hospice focuses on providing comfort, dignity, and emotional support not only for patients but also for their families, loved ones and caregivers.
Our hospice care team is there to support family members, loved ones and caregivers through our extensive social work, spiritual care, volunteer services, respite and bereavement services.
Myth: A patient needs Medicare or Medicaid to afford hospice services.
Reality: Insurance coverage for hospice is available through Medicare, Medicaid and most private insurance plans. Some programs charge patients co-pays and other fees in accordance with their ability to pay.
Islands Hospice provides free care to all terminally ill patients regardless of ability to pay.
Myth: A physician decides whether a patient should receive hospice care and which agency should provide that care.
Reality: The role of the physician is to recommend care, whether hospice or traditional curative care. It is the patient’s right (or in some cases the right of the person who holds power of attorney) and decision to determine when hospice is appropriate and which program suits his or her needs. Before entering a hospice, however, a physician must certify that a patient has been diagnosed with a terminal illness and has a life expectancy of six months or less.
Myth: To be eligible for hospice care, a patient must already be bedridden.
Reality: Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient’s physical condition. Many of the patients served through hospice continue to lead productive and rewarding lives. Together, the patient, family, and physician determine when hospice services should begin.
Myth: After six months, patients are no longer eligible to receive hospice care through Medicare and other insurances.
Reality: According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, he or she can continue receiving hospice care as long as the attending physician re-certifies that the patient is terminally ill. Medicare, Medicaid, and many other private and commercial insurances will continue to cover hospice services as long as the patient meets hospice criteria of having a terminal prognosis and is re-certified with a limited life expectancy of six months or less.
Myth: Once a patient elects hospice, he or she can no longer receive care from the primary care physician.
Reality: Hospice reinforces the relationship between a patient and primary care physician by advocating either office or home visits, according to the physician's preference. Hospices work closely with the primary physician and consider the continuation of the patient-physician relationship to be of the highest priority.
Myth: Once a patient elects hospice care, he or she cannot return to traditional medical treatment.
Reality: Patients always have the right to reinstate traditional care at any time, for any reason. If a patient’s condition improves or the disease goes into remission, he or she can be discharged from a hospice and return to curative measures, if so desired. If a discharged patient wants to return to hospice care, Medicare, Medicaid, and most private insurance companies and HMOs will allow readmission.
Myth: Hospice means giving up hope.
Reality: Hospice helps patients reclaim the spirit of life and make the most of the life that remains. It helps them understand that even though death can lead to sadness, anger, and pain, it can also lead to opportunities for reminiscence, laughter and healing of mind and spirit. At Islands Hospice our staff and volunteers are experts in bringing hope to the last chapter of life.