What are the advantages of hospice?
Hospice treats the person, instead of the disease; focuses on the family, instead of just the individual; and emphasizes the quality of life, instead of its duration. Hospice care allows terminally ill patients and their families to experience the end of life together, in the comfort and security of home or a home-like setting. Hospice uses the combined knowledge and skills of an interdisciplinary team of professionals, including physicians nurses, home care aides, social workers, spiritual caregivers, counselors, and volunteers. Hospice care is a cost-effective alternative to services provided in hospitals, nursing homes, and other institutional settings. Hospice is the preferred choice of health care delivery for the terminally ill and their families.

What services are provided?
Medicare-certified hospices are required to provide nursing care; social services; physician services; counseling services (including spiritual and dietary); home care aide and homemaker services; bereavement services; physical and occupational therapies; and speech-language pathology service. Short-term, in-patient (for respite, pain control, and symptom management), continuous care in the home, and medical equipment and supplies (including drugs and biologicals) are also available. Additional services can be offered. Therefore, the range of hospice services may vary from program to program. Care is structured to keep families together in the least restrictive environment possible.

Who is eligible?
A person is eligible for hospice under the Medicare Hospice Benefit once he or she is certified by a physician as having a terminal illness with a life expectancy of six months or less. Hospice is available to all terminally ill individuals and their families regardless of their age, gender, race, nationality, creed, sexual orientation, physical condition, availability of primary caregiver, or ability to pay. Although nearly 59% of the patients who were admitted to hospice agencies in 1994 had conditions related to cancer, other frequent admission diagnoses include heart and lung disease, AIDS, and neurological disorders.

Who pays for hospice care?
Hospice services are covered by Medicare, the Medicaid programs of 41 states and the District of Columbia, and most private insurance and managed care plans. In addition, military personnel and their dependents can receive hospice under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Hospices heavily rely on grants and community support to fund services for patients with little or no insurance.