Frequently Asked Questions
“We thought hospice meant that Mom was going to die. Now, I realize it just means that she’s living better – with more people caring for her and loving on her.”
- A patient’s family member
What is hospice?
Hospice is a service, not a place. It is compassionate, specialized healthcare and support for terminally ill patients with diseases including cancer, Alzheimer’s disease and other types of dementia, end-stage kidney disease, end-stage liver disease, HIV/AIDS, ALS and other end-stage neurodegenerative diseases, and end-stage heart and lung disease. Hospice is expert at bringing peace and dignity to the serious illness and dying experience, but Hospice of the Piedmont is different from other hospices in that the centerpiece of our unique care model is that we also support patients’ loved ones during a time of great worry, stress, and grief. HOP provides ongoing, comprehensive bereavement support for families, children to adults, in our many grief programs, classes, groups, and events for a year following the patient’s death.
Are all hospices alike?
No. While all hospices specialize in care for the terminally ill, they can differ greatly in the quality of care and range of services. Many hospices are part of large, for-profit healthcare corporations, while others operate as not-for-profit organizations. Hospice of the Piedmont is a not-for-profit healthcare provider and the oldest, most experienced hospice in the region, serving tens of thousands of patients and families in our 12-county service area since 1980. Being local and community-based means we are free to create new, innovative programs to serve our patients and their loved ones, such as our Hospice House, Center for Acute Hospice Care, Center for Children, and Center for Grief & Healing. Hospice is a choice: It’s smart to get the advice of friends, coworkers, and neighbors about their experiences with hospice so you can make an informed decision that works best for you and your loved ones. For more information about hospice care providers throughout the United States, visit the National Hospice and Palliative Care Organization (NHPCO) website.
Who Hospice Serves
Who is eligible for hospice?
Anyone facing the late stages of any terminal illness is eligible for hospice care.
Hospice care is appropriate when:
- The physician, along with the HOP Medical Director, believes that the patient will live six months or less if the disease runs its normal course.
- The patient, family, and physician understand and agree that the medical focus is on comfort (pain control and symptom management), not cure.
What are the most common diseases in patients that Hospice of the Piedmont serves?
About 55 percent of hospice patients have cancer; the rest have Alzheimer’s disease or other types of dementia, ALS and other neurodegenerative diseases, heart disease, lung disease, kidney disease, liver disease, HIV/AIDS, and other terminal illnesses.
Why do terminally ill patients choose hospice?
Many patients diagnosed with terminal illness want to live the remainder of their lives in the comfort, security, and familiarity of home surrounded by the people they love. Hospice patients are making a choice to pursue comfort care instead of continued curative treatment. Hospice care through HOP empowers patients and loved ones by giving them control over care. A big part of that is pain control and symptom management. Living fully is easier when the patient isn’t in pain. We prioritize quality of life for people with life-limiting illness, providing peace and comfort to patients and loved ones.
Must a hospice patient be ready to accept death?
Although patients receiving hospice care must have a terminal diagnosis, patients may go through many stages of acceptance or non-acceptance. Patients are never pressured to discuss end-of-life issues.
How Hospice Works
How does hospice work? Who provides the care to patients?
The Hospice of the Piedmont team of nurses, social workers, home health aides, chaplains, and volunteers, under the guidance of a hospice-certified physician, make regular, scheduled visits to patients and their loved ones wherever the patient is: at home or in a hospital, nursing home, assisted living facility, retirement
community, our Hospice House, or our Center for Acute Hospice Care. The hospice team teaches caregivers how to support the patient, training them in dispensing medication, caring for catheters, and other medical duties. The hospice approach works because it empowers family members and caregivers in the end-of-life care process, and at the same time supports them with ongoing expert help and advice.
Does hospice provide 24-hour nursing care in the home?
That’s not how hospice works. However, Hospice of the Piedmont provides continuous skilled nursing care in the home for short-term crisis periods that require complex symptom management. Typically, our home care program, like other hospices, provides intermittent, skilled visits on an as-needed basis to support the patient and primary caregiver. A professional member of the patient care team is also available around the clock, seven days a week, to answer questions and assist with emergencies.
Does Hospice of the Piedmont have a residential facility?
Yes. Our Hospice House is a beautifully restored, eight-bed Victorian home located at 501 Park Street in the historic district of Charlottesville. It is one of only a few licensed, credentialed hospice houses in the state of Virginia.
What happens to a hospice patient who lives longer than six months?
Hospice benefits do not expire at six months. Patients can continue in hospice if their health is still declining and the ongoing assessment of the patient by the hospice medical director, in consultation with the interdisciplinary care team, is a six-month prognosis. Occasionally, thanks to the skilled efforts of our hospice team, a patient’s health can improve so much a six-month prognosis is no longer accurate. So, we celebrate a graduation from hospice services and help to coordinate care services with the attending physician in the transition.
The Cost of Hospice
How much does hospice care cost? Is it affordable?
Studies have shown that hospice care provides expert pain management and is more cost-effective than hospitalization. Medicaid and Medicare, as well as most health insurance carriers, have a benefit that covers the cost of hospice care. The majority of Hospice of the Piedmont’s hospice and grief support services are provided at no cost to patients and their families. For more information, contact the Hospice of the Piedmont Admissions Department: 434-817-6900 or toll-free 1-800-975-5501.
How is Hospice of the Piedmont, a not-for-profit hospice, funded?
Approximately 85% of our revenue comes from insurance reimbursements and 15% comes from donations by individuals, businesses, and foundations. As a community-owned healthcare provider, Hospice of the Piedmont relies on the generous support of volunteers and donors to ensure we can provide high-quality hospice care and comprehensive grief support to patients and families, regardless of ability to pay. We do not receive funding from local, state, or federal governments.
Getting a Referral for Hospice Care
Who can refer a patient to Hospice of the Piedmont?
While most referrals come from hospitals, family members, or physicians, anyone, including the patient, a friend, or neighbor can refer someone to hospice. To begin the referral process, with no obligation or cost, call Hospice of the Piedmont Admissions Department: 434-817-6900 or toll-free 1-800-975-5501.
When should a patient be referred for hospice?
There are three main categories to consider: function, nutrition, and cognition. These conditions are valid across all diagnoses. If a patient is elderly and frail (over 75 or 80 years old with multiple significant and life-limiting conditions), the following conditions may warrant referral to hospice services:
- Unexplained weight loss of more than 10% of body weight in the past six to twelve months
- Inadequate nutrition/hydration with a steep/acute curve of decline
- Cognitive decline, with additional significant, life-limiting health conditions (dementia as a primary diagnosis has specific criteria)
How does a physician refer a patient to hospice?
To certify that a patient is eligible for the hospice benefit under Medicare, two physicians must clinically judge that the patient has six months to live or less: the HOP Medical Director and another referring physician (either the patient’s primary care doctor or a specialist). Medicare provides guidelines for referring patients. But, if clinicians are uncertain about a potential referral, request an evaluation at no cost to the patient or family. Hospice of the Piedmont will send a skilled staff nurse to evaluate the patient, in accordance with the physician’s best medical judgment and Medicare guidelines, and in collaboration with the Hospice Medical Director. Our Senior Medical Director Angela Stiltner, MD, HMDC, the only full-time hospice medical director in the region, is also available to discuss potential referrals: 434-817-6900 or toll-free 1-800-975-5501.
What is the difference between hospice and palliative care?
Hospice referrals must meet the Medicare guidelines for accessing the Medicare Hospice benefit. Patients must elect to use the Medicare Hospice benefit, which covers 100% of costs related to care associated with the admitting diagnosis, including medications and durable medical equipment. The patient must have an estimated six-month prognosis and must choose not to pursue curative or aggressive medical treatment.
Palliative care focuses on the relief of symptoms, pain, and physical and mental stress of serious illness. Palliative care, at the patient’s request, is often used along with other medical care, including while undergoing aggressive or curative treatment. Sometimes palliative care discussions result in hospice referrals if that’s what patients want. Most of the time, a palliative care assessment results in improved symptom management and enhanced quality of life.
Do you have questions about how hospice can help?
We’re glad to answer them.
Contact Hospice of the Piedmont now: 1-800-975-5501, 434-817-6900, or [email protected]