A patient is eligible to receive hospice services when their illness is terminal. A physician determines the patient’s life expectancy is six months or less if the disease runs its ordinary course. In addition, the patient must meet Medicare’s disease-specific criteria.

Hospice is for people who have a limited life expectancy and patients whose condition is such that a doctor would not be surprised if the patient died within the next six months. This doesn’t mean the patient will die in the next six months; it simply means that ​he or she has a condition that makes passing a realistic possibility.

When treatment options for a disease have been exhausted or are no longer working, 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 a patient’s life by being free of pain, surrounded by family, and in the comfort of their home.

在 COVID-19 期间，在生活辅助设施、疗养院或医院寻找护理服务可能会更加复杂。不过，这些机构可能会继续更新其服务和政策，以符合各州卫生部门和疾病预防控制中心的指导方针，从而保护接受护理的人员和提供护理的工作人员的健康和安全。从疾病预防控制中心了解更多信息。

If you have questions or concerns about these uncertain times, one of Sage’s social workers or care managers will be glad to assist you by calling (404) 763-1456.

Anyone can request a hospice evaluation at no cost. A physician may make the referral or provide several options and let the patient/family decide. The physician must certify to the hospice provider that the patient is eligible and has a prognosis of six months or less.

When a referral is made, the hospice provider makes an appointment (the same day or on a convenient date) to meet with the patient and family. The admissions nurse evaluates the patient, answers the family member’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, they sign admission paperwork, and the hospice team begins to visit.

The hospice nurse creates a plan of care with the patient’s and family’s input designed to meet the patient’s needs and determines the frequency of visits by the hospice staff. A hospice nurse can make additional visits if needed, 24 hours a day, seven days a week.

A person may withdraw from the hospice program for various reasons, such as resuming aggressive, curative treatment or pursuing experimental measures. Also, 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 and return at any time, as long as their doctor recertifies their eligibility.

While a patient is not required to sign a DNR order before being admitted to hospice, some hospice providers may ask you to sign the order. However, as long as the patient and his family understand that hospice offers palliative care rather than curative care, any Medicare-certified hospice will not ask the patient to sign the DNR order.

预先指示这一术语描述了两种法律文件，它们可以让个人在无法再表达知情同意的情况下计划和传达自己的临终愿望。这两种文件是生前预嘱和医疗授权书。

生前遗嘱：允许个人记录自己在生命终结时对医疗治疗的意愿。

医疗委托书：这允许个人指定其信任的人作为其医疗保健代理人（或代理决策者），授权其代表自己做出医疗决定。

要了解更多信息，请访问我们的文章《预先指示》：什么是 DNR 和 DNI 命令？

While hospice strives to manage pain and other symptoms outside of the hospital setting, the patient always has the choice to go to a hospital. The Medicare hospice benefit covers short-term general inpatient care in the hospital when a patient’s symptoms can no longer be managed in another care setting. A written agreement between the hospital and hospice provider is required, and the patient and/or family should always contact the hospice nurse before going to the hospital.

A hospice patient may continue to see their PCP. In addition, hospice physicians and team members work with the patient’s PCP to ensure their clinical and emotional needs are being met and that their care is being carried out appropriately. Their PCP chooses his or her level of participation in their care. A patient must get permission from their hospice provider to see any other physicians/specialists outside their PCP for their terminal condition.

Unlike home health, there is no homebound rule for hospice patients. However, they are encouraged to travel outside of the home, if they are able, to promote quality of life.

Home health care patients require skilled care and must show improvement from this care. When these goals are no longer realistic, the patient can be transferred to hospice care. In addition, home health and hospice can provide services if the home health diagnosis is unrelated to the hospice diagnosis.

Nursing homes focus on routine daily care and rehabilitation. Nursing home patients 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.

No. Generally patients recieve palliative care before hospice.

Though the terms often get confused, palliative care isn’t the same as end-of-life care or hospice care. You can receive palliative care at any stage of your illness, and being on palliative care doesn’t mean your doctors stop trying to cure your condition.

Hospice care is for people who have an incurable illness and are approaching the end of life, and treatments meant to stop your disease are halted. The goal of hospice and end-of-life care is to ensure comfort during your final days and to provide emotional support for you and your loved ones. You can receive hospice care at home or at a hospice facility.

Learn more: When should someone be offered palliative care? and 8 Signs It’s Time to Call Hospice