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Hospice Information | Shangrila Hospice

General FAQ

Tools, Resources and Information You’re Looking For

Is hospice just a place to go to die when there is nothing else your doctor can do?

There are many misconceptions about hospice that may prevent patients and families who would benefit from hospice care from seeking out the support that hospice can provide. Choosing hospice is a movement into another mode of care-giving when a terminal illness no longer responds to cure-oriented treatments.

How do you know when hospice is appropriate?Click here to edit.

The patient, family and/or physician can initiate a hospice information/referral call or visit as soon as a terminal disease is diagnosed. When the patient would like to move from a treatment plan focused on curing the disease to a plan focused on providing comfort and relief, they may choose hospice care. At this point, the local hospice workers will meet with the patient's personal physician, the patient and the family to discuss available services and expectations and to develop a plan of care designed specifically for the patient and family needs.

What are some of the questions I should ask when selecting a hospice? Is there a set of criteria that can help in my decision?

Individuals will have different medical, financial, emotional and spiritual needs when dealing with a life-limiting illness. When choosing hospice, it is important to be honest about your family's own needs and feelings. Then, you may want to ask questions about insurance plans and payment requirements. Ask what expectations the hospice will have from the patient and the patient's support system. Ask what kind of support and training program the hospice has for caregivers. Also, ask about bereavement support programs. View the brochure, "Choosing Hospice: Questions to Ask."

My family has very little financial resources. How is hospice care paid for?

Hospice care is a covered benefit under Medicare for patients with a prognosis of 6 months or less. Medicaid covers hospice services in most states. Also, many private health insurance policies and HMOs offer hospice coverage and benefits. Hospice services are also covered under TRICARE. Frequently, hospice expenses are less than conventional care expenses during the last six months of life.

Legally, if a person is active under hospice services should there be a physician order for "DNR?"

A “DNR” is, of course, a “Do Not Resuscitate” order. Patients do not need to have a DNR order signed at the time of their enrollment into hospice. Often, physicians rely on hospice to get a DNR order because they are reluctant to hold the discussion with patients themselves. If DNR were a legal requirement, referrals to hospice would be postponed and length of hospital stay would be even more dismal than it already is. However, hospice staff will work with the family to determine the best time to have a DNR order signed after enrollment.

How do I truly reach out to, and help, someone on hospice care?

Sometimes, the terminally ill often feel a sense of abandonment when they choose hospice, because the loved ones who should be supporting the dying are not sure of how to express themselves. When you feel awkward or helpless, follow these steps:

- Venture: Convey your empathy and show your interest and concern. Acknowledge opportunities for conversation. A simple "how are you doing?" can convey your interest and concern. After the initial response, follow your friend's lead. Sometimes he may want to talk about the experience, while other times he might want to avoid the issue.

- Validate: Respect and validate difficult feelings, fears, and sad thoughts. Rather than saying, "You should not feel guilty, angry, or afraid," let the person express those feelings. Asking "What makes you angry?" or "I understand you're frightened," allows individuals to further explore their feelings. Share advice when asked, but mostly listen.

- Volunteer: Help in tangible ways and volunteer to do specific things. It is not enough to say, "Is there anything I can do?" A person living with illness or caring for someone who is, may be too stressed to consider how you might help, or might believe you are just trying to be polite. Tangible acts such as cooking food, helping with chores, or assisting in caregiving, can mean so much to friends in crisis.