Frequently Asked Questions (FAQ’s)

What is Hospice Care?

Hospice Care is provided by a team of professionals who help the patient, their family members and caregivers cope with the unique demands at the end of life, specifically symptom management and pain control. This caregiving team includes a Medical Director, APRN/PA, Nurses, Social Workers, Home Health Aides and Homemakers, Spiritual Counselors and trained community Hospice Volunteers.

Hospice Care is provided wherever the patient calls home. Most all insurances have a Hospice benefit that covers Hospice Care at no cost to the patient, including medications, medical equipment, supplies and regular visits from the hospice team.

Who is eligible for Hospice Care?

Eligibility for Hospice Care, as defined by the federal Medicare Hospice Benefit, begins when a provider determines a patient has six months or less to live if their illness runs its natural course. We care for many patients who have a diagnosis of cancer, congestive heart failure (CHF) chronic obstructive pulmonary disease (COPD), dementia/Alzheimer’s, liver disease, kidney disease, and stroke.

When is it time for Hospice?

It can be very difficult for a provider to determine the timeline of a patient’s illness and many of our patients tell us they “wish they knew about us sooner.” To help you decide whether it’s time to consider Hospice Care, see the questions below. If the answer is ‘yes’ to two or more, call North Country Home Health & Hospice to discuss options. Then, in consultation with your provider, we can help you think through what’s best for you and your family.

Have you or a loved one:

  1. Been hospitalized several times in the last six months?
  2. Used medication more frequently to ease pain symptoms?
  3. Needed help with two or more of the following?
    • Bathing
    • Dressing
    • Eating
    • Walking
    • Getting out of bed or a chair
  4. Had unexplained weight loss in the last year?
  5. Had shortness of breath while resting?
  6. Been diagnosed with a serious illness by a provider and told that life expectancy is limited?

What is the difference between Palliative Care and Hospice Care?

Palliative Care is provided to patients who are living with a serious illness. Usually Palliative Care is provided in the hospital setting, to help manage symptoms for illnesses that may not be life-limiting. Generally, patients can be early on in their diagnosis and receive Palliative Care to assist them with pain management and symptom control. A patient can receive curative treatment while receiving Palliative Care.

Hospice Care is provided to patients wherever they call home. Generally our patients have an illness that they are not seeking any curative treatment for. The goal of Hospice Care during a terminal illness is to provide compassionate care and comfort, rather than a cure. Hospice Care also focuses on symptom management and attends to patient’s needs in order to enhance their quality of life.

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 provider, other health care professionals, clergy or friends.

Will I have to change heath care providers if I am admitted to hospice services?

No.  Patients have the right to choose and keep a primary care provider. The provider will work with the hospice team to develop a plan for care and symptom management.

Common Misconceptions:

You have to be homebound in order to qualify for Hospice:

This is false. Patients do not have to be homebound in order to qualify for Hospice care.  We actually encourage our Hospice patients to enjoy themselves and check boxes off their “bucket-list.” If they wish to get out of the house, go for a ride, take a short vacation we are there to support them and even facilitate these adventures.

You have to be actively dying to be on Hospice:

This is false! What is most beneficial for the patient and our team is to have time to spend with the patient and develop a relationship before a patient is actively dying. Many of our patients that come onto Hospice early on are independent, have the ability to make their wishes and choices known, can participate in their care and have the chance to build a bond with their Hospice team. Many of our patients still drive and do their own groceries when they come onto Hospice.

You have to have a caregiver to qualify for Hospice:

 We do require that our patients have a caregiver that will assist them 24/7 when the time comes that they need full care. As a Hospice agency we do not provide 24/7 care, but we do have the resources to help facilitate that care if needed. If you think you qualify for Hospice, but do not have a caregiver, please call us to discuss your needs. We always strive to help patients set up caregiving services and would never turn anyone away without trying to assist them.

Hospice means going home to be started on an IV Morphine drip:

 This is very false. Our goal is comfort and symptom management; however, only a very small percentage of our patients actually receive IV medications. With the help of our Medical Director and Primary Care providers, we are able to manage symptoms in the home, using medications taken by mouth; creams and patches placed on the skin. We also have Volunteers that provide Massage and Reiki Therapy.

 

Covid 19 Update

Patient Guide for COVID-19

This document is provided by the National Association for Home Care & Hospice. https://www.nahc.org/resources-services/coronavirus-resources/

Steps for people with confirmed or suspected COVID-19 (including persons under investigation) who do not need to be hospitalized and people with confirmed COVID-19 who were hospitalized and determined to be medically stable to go home.

Your healthcare provider and public health staff will evaluate whether you can be cared for at home. If it is determined that you do not need to be hospitalized and can be isolated at home, you will be monitored by staff from your local or state health department. You should follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities.

Stay home except to get medical care

You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from other people and animals in your home

People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.

Animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a facemask.

Call ahead before visiting your doctor

If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Wear a facemask

You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.

Cover your coughs and sneezes

 

Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can; immediately wash your hands with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

 

Clean your hands often

Wash your hands often with soap and water for at least 20 seconds or clean your hands with an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items

You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.

Clean all “high-touch” surfaces everyday

High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

Monitor your symptoms

Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.

If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a facemask before emergency medical services arrive.

Discontinuing home isolation

Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

Source: CDC, Preventing the Spread of Coronavirus Disease 2019 in Homes and Residential Communities, Interim Guidance