How to Choose a Hospice

Questions you should consider before choosing.

When you pick up the phone, can you speak with the top leaders?

If the leadership of a particular hospice won't speak with you, then they are probably too big to meet your needs.  Place a "test" call to see how they respond. We believe patient care has to be the most important issue of the day - every day, at every level of the organization.

Is the hospice state licensed?

Every hospice must be state licensed.  In addition, a hospice must be Medicare certified in order to cover services provided to Medicare recipients.

Is the hospice accredited?

Ideally the hospice will be accredited by either CHAP (Community Health Accreditation Program) or JCAHO (Joint Commission on Health Care Organizations).  These are voluntary accreditations, but only the "best" hospices attain them.

Is the hospice "on call" 24-hours a day, 7 days a week?

All hospices are supposed to be available 24/7.  You should also ask, "How far away is the on call nurse for my area"?

Is your hospice non-profit or for-profit?

This is an important difference.  Non-profit hospices are governed by a voluntary board of directors.  For-profit hospices are businesses with individual owners or a group of owners.

How long has the hospice been serving the area?

Opt for a hospice that has a reputation of serving the community for many years; ask family, friends and your physician for recommendations.

Is hospice care just for cancer patients?

This answer should always be "No."  Hospice care is for all types of patients with different diagnoses such as dementia and Alzheimer's, end stage heart and/or lung disease, ALS, HIV/Aids, Multiple Sclerosis and Muscular Dystrophy, Parkinson's Disease, stroke, and renal failure.  Medicare regulations define "terminally ill" as a medical prognosis with a life expectancy of "6 months or less if the illness runs its normal course."

Is hospice care just for the elderly?

Hospice care is for anyone who needs it.  A hospice with a pediatric program is truly living its mission ensuring that end-of-life care is provided to anyone who is eligible - regardless of age.

How do I sign up for hospice service?

Anyone can inquire about hospice services.  When a hospice is contacted, they call the appropriate  physician to obtain accurate information and a "go-ahead" for hospice care.  Your physician is crucial in helping secure hospice services.

Can someone help me with Advance Directives/Living Wills?

The answer from any hospice should always be "Yes."  A thorough explanation with definitions and answers to any questions you have should be available to you.

Services truly separate one hospice from another.

There are eight "basic" services.  There are also important questions to ask regarding each one.

1.  In-home skilled nursing and medical oversight

How often does a nurse visit the home?  What is the average number of visits per week per patient?

2.  Medical direction

Who are your Medical Directors?  What type of medical background do they have? Is the Medical Director certified in hospice and palliative care?

3.  Medications related to the life-limiting illness

Does your hospice have its own pharmacy and pharmacist on staff?  What credentials does your pharmacist have?  You want to be certain that the hospice can obtain the proper medications for you as quickly as possible.

4.  Social services

What about counseling for my family?  What type of training do your counselors have?  Do you have a child life specialist in case my children/grandchildren need additional comfort and support?

5.  Chaplain and spiritual services

How often can a chaplain visit me?  Are they educated about and supportive of all types of faith?

6.  Home Hospice Aides to assist with personal care

Are they certified (CNA)?  How often are they available to help my family and me?

7.  Bereavement services

Do you have special programs for children?  Do you have a bereavement counselor?  What are the counselor's credentials?  Do you have on-going support groups?  What if I need to speak with someone immediately?

8.  Medical equipment such as hospital beds, etc.

How soon should I expect to receive the proper equipment?  How soon would it be picked up after we no longer need it?