Hospice Care FAQ

Hospice is not a place, though you may hear of certain in-patient facilities that offer hospice services. It is a term for a type of healthcare focused on keeping the patient comfortable once the underlying disease can no longer be treated or cured. Hospice neither hastens nor postpones death. It is focused on helping the patient achieve a peaceful and pain-free transition. The hospice team helps manage the patient’s pain and symptoms, and they provide emotional and spiritual support so the patient can make the most of the time they have left.

At any time during a life-limiting illness, it’s appropriate to discuss all of an individual’s care options, including hospice. Making the choice to discontinue medical treatment is often made when all curative measures have been exhausted and the patient wants the comfort and dignity offered by hospice care. Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family, and physician. In short, a patient is eligible for hospice when the patient’s doctor says that the underlying condition carries a life expectancy of six months or less. Starting hospice sooner than later provides the patient and family with the full breadth of our services. Care can continue beyond six months as long as the patient meets the medical criteria.

When facing a serious illness, the patient and family are encouraged to discuss hospice care at any time with their physician, other healthcare professionals, clergy, or friends. It is important to remember that the earlier the referral is made, the sooner the hospice team can make the individual’s final months or weeks as comfortable as possible.

No. It is common for a personal physician to provide a list of local hospice agencies that they are familiar with. You can choose from that list or go with another option — it is entirely your choice. Not all hospices are the same. Research the quality scores of all Medicare-certified hospice companies at HospiceCompare.org.

No. Hospice care is available for anyone who has a terminal illness with a prognosis of six months or less. Other common degenerative conditions include heart disease, compromised respiratory function, and neurological disease; this is not an exhaustive list.

Part of the decision to begin hospice has to do with readiness to discontinue curative therapies. If the patient/family are seeking symptom management and want to still pursue curative care, Hope’s palliative program may be the better fit at this time.

For some diseases, primary care cannot adequately address the patient’s pain and symptoms. Unfortunately, these individuals commonly undergo multiple hospitalizations. Hospice is a much higher level of care than one can receive from a primary physician. Our team has a wealth of expertise and specialized education in comfort care and pain management. We offer a circle of support and pay attention to all of an individual’s needs — physical, mental, emotional, and spiritual. Hospice services are provided in the comfort and privacy of home, offering the family time and space to be together, to have pets present, and to otherwise have control of their environment. This is not the case in a hospital setting.

An individual can be referred in a variety of ways: by their primary doctor or specialist, by a family member or friend, by a nursing home or assisted living facility, or through a hospital. No matter how the referral is initially made, the patient’s doctor must approve the referral, confirm the six month prognosis, and then complete the referral with a formal order.

Families often initiate the process and request that we contact the doctor. You can start your family referral using this referral form or call our Admissions team at (781) 832-0705. A Hope representative will then contact the patient’s physician to acquire certification that hospice care is appropriate for the patient at this time. If the individual does not have a doctor, Hope’s medical director is available to provide oversight. We visit the patient/family to explain how our hospice program works. If the patient/family decide to move forward and begin hospice, they are asked to sign consent and insurance forms similar to those used when entering a hospital.

The patient has the right to revoke hospice care at any time. Sometimes, the patient’s disease stabilizes and they and no longer meet the medical criteria for hospice. In that case, the patient is discharged and referred to our palliative care program for continued support. The patient can return to hospice care if their condition declines and they are once again hospice eligible.

Medicare, Medi-Cal, and most private health insurance plans fully cover hospice care, including nurse visits, supplies, medications, and need medical equipment for the home. If no coverage is available, Starr Hospice will provide care through the generous donations provided by the community.

Hope’s hospice care is delivered by a qualified team of professionals with specialized training in hospice care. The hospice team includes a medical director, nurse, social worker, home health aide, spiritual counselor, and trained volunteers who work together to support the patient and family in this time of need. We routinely collaborate with the patient’s primary care physician, who directs the hospice team in providing comprehensive care.

No, it is not necessary to change doctors. Starr Hospice works directly with an individual’s physician assuring that, through close collaboration, the patient receives care that meets their individual needs.

No. At the initial visit, our team prepares a comprehensive individualized care plan including an assessment of the patient’s needs regarding medical equipment (like a hospital bed), personal care supplies, and pain medication.  In addition to noting the needs of the patient, we determine the amount of care required. Follow-up nurse visits are performed as needed in between phone check-ins. Additionally, home health aide services for personal care are scheduled according to a patient’s individual needs.

This plan of care is very customized and may change over time. The hospice team will conduct ongoing assessments and make recommendations to meet the patient’s needs and help find resources as additional help is necessary.

The family care partners play a big role in providing quality care to the patient. Our team will educate the family on how to care for the patient on their own in between nurse visits.

The number of visits and duration of visits are determined by the patient’s needs. In addition to scheduled nurse visits, we provide an on-call nurse, available by phone for medical advice or for emergency visits 24 hours a day, 7 days a week.

Though most people prefer to be cared for at home, Hope can also provide hospice care for patients who live in skilled nursing facilities, assisted living residences, or board and care homes.

Patients who require 24-hour nursing typically reside in a skilled nursing facility. While the on-site nurse team monitors the patient and provides interventions as needed, the hospice team delivers specialized services for end-of-life care. Hope coordinates care with the staff of the facility to provide an integrated approach. Consider hospice as a complement to the care from the facility.

When an individual chooses to receive hospice care they may have some new and special needs. The hospice team assesses those needs, recommends any necessary equipment, and helps make arrangements to obtain it. This equipment is covered by the hospice benefit. The need for equipment is usually minimal at first and may increase over time.

The answer here is specific to the individual patient. In the early weeks, and depending on the patient’s faculties, some independence may be able to be preserved. Over time, the hospice team may recommend that someone be with the patient continuously. While family and friends must be relied on to give most of the care, Starr Hospice does provide trained volunteers to assist with errands and to allow relief for caregivers. We also provide a referral list of caregiving agencies for families who wish to hire additional help.

No. Hospice does not speed up or slow down the dying process.

Hope nurses and doctors are experts in managing pain and have a high degree of success in pain control. The hospice staff check with the patient frequently to assure the they are comfortable. The doctors and nurses on the team consult with a pharmacist weekly and remain current on the latest medications and treatments for pain and symptom relief.

Feedback from patient satisfaction surveys confirms that we have an exceptionally high success rate in helping patients attain a level of comfort that is acceptable to them. The benefits of managing pain include ease with rest, eating, and socializing. Patients can participate in activities they enjoy the most.

It is the goal of Starr Hospice to help patients be as comfortable and alert as they desire. Some people may react to an appropriate pain medication by becoming sleepy until their bodies adjust to the dose. By frequently consulting with the patient, our team has been very successful in balancing pain control with the ability to interact with others.

Dying is a natural physical, emotional, and spiritual process that is part of life. Our team of caring professionals can provide guidance, instruction, and support to help the family learn what to expect as their loved one nears the end of life. Our social workers, vigil volunteers, spiritual counselors, and grief support team stand ready to help before, during, and after the death of a loved one.

Starr Hospice offers grief support for family and friends following the death of a loved one in our care. We also offer support groups and activities for adults, teens, or children in the community who have experienced the death of a family member, friend, or loved one but have not used hospice care.

Our social workers are specially trained to provide resources and guidance in a variety of legal and ethical matters and have ready access to Advanced Directive forms. Some documents are simple, such as Five Wishes and the Physician Order for Life Sustaining Treatment (POLST), and you can fill them out easily. Others may require professional advice, and have a list of referral resources.

No. Starr Hospice is a non-sectarian, nonprofit organization. Our Spiritual Care Providers support patients and families of any faith tradition and no faith tradition.

Hospice care is available for everyone, without discrimination on the basis of race, color, national origin, religion, sex, physical or mental disability, medical condition, age, veteran status, ancestry, sexual orientation, gender identity, marital status, or citizenship. Starr Hospice respects and supports cultural differences in regards to providing our end of life care and grief support.

Starr Hospice serves the Tri-Valley and neighboring cities of the San Francisco East Bay Area. View a map here.