Eldercare Planning: Where Can You Receive Hospice Care?

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Hospice provides comfort care for people who are terminally ill and in the last stages of their life. It’s all about giving the best possible quality of life to someone who has just months left to live. As with any life changing event, being prepared makes a difficult situation a little easier. We’re going to explore where you can receive hospice care and why an estate plan needs to be part of your eldercare planning.

What is Hospice?

This is a focused type of care for a person who has a serious illness and there is no hope for a cure, or the patient has chosen not to undergo or continue treatments for an advanced illness. Hospice is typically provided when doctors have determined the patient has six months or less to live. Patients receive medications for pain management and comfort.

The Hospice Foundation of America explains that a hospice care program is an interdisciplinary team of specially skilled nurses, doctors, social workers, dieticians, therapists, home health aides, bereavement counselors, clergy, and volunteers. The team provides patients emotional, spiritual, and medical support. In addition to caring for the patient, their families are also provided support and guidance.

Prepare Your Estate Plan for Hospice

Before we break down where you can receive hospice care, let’s talk about what important estate planning documents you should have long before you or a loved one develops a serious illness and needs hospice care. Give yourself and your loved ones peace of mind by having crucial estate planning documents in place before a crisis hits.

Related: Planning for Incapacity: Documents to Have and Steps to Take

Among the documents you should have are:

  • Power of Attorney – This person you appoint has legal authority to manage all your financial and business matters. A Power of Attorney can pay your bills, sign legal papers, file taxes, and handle your financial accounts. 
  • Health Care Proxy – Do you want artificial nutrition? Do you want resuscitation? When do you want to end life sustaining treatment? If you cannot make your own medical treatment decisions, your Health Care Proxy becomes your voice. You should choose someone you trust as your proxy to carry out your health care wishes. In some states, you can list the medical treatments you want or don’t want and under what circumstances along with end-of-life care in the Health Care Proxy document. There are states where a Living Will – also known as an advanced directive – is needed to spell out your medical care and end-of-life preferences. Both the Living Will and Health Care Proxy work together, and with Gentreo, they’re combined into one document.
  • Last Will and Testament – Ensure your final wishes are honored by having a Will. In this document, you choose how your estate should be distributed after you pass. A Will allows you to name beneficiaries – family members, friends, or charities – that you want to have your assets. 
  • Trust – Placing your home and financial assets in a Trust can save lots of hassle and streamline the implementation of your estate plan when you die. Upon your passing, the assets transfer directly to the beneficiary you name in the Trust without going through probate, unlike with a Will.

If you do not have these documents and something happens to you, the consequences can be dire. In the case of not having a Power of Attorney or Health Care Proxy, if you cannot make your own decisions, your loved ones would have to petition the court for guardianship so they can act on your behalf. If you die without a Will, the state steps in and decides how your estate will be distributed. Having estate planning documents puts you in control.  

Related: Why Estate Planning Should NOT Wait: What We Learned From Dad’s Recent Passing

Where Can I Receive Hospice Care?

Hospice care is offered in various settings. These include:

  • In your home – Family members are the primary caregivers for in-home hospice. Preparing your meals, giving medications, personal care, grooming, and helping you move around the house are their basic duties. Members of the hospice team such as nurses and home health aides make scheduled visits to provide assistance, treatment, and support and are on-call around the clock if needed. Medical equipment such as a hospital bed, a wheelchair, and delivery mechanisms for feeding and medications can be rented.
  • Assisted living facilities – If you’re in need of hospice, you don’t need to leave your community, and can receive this care in assisted living facilities if your home is not suitable or your loved ones are ill-equipped for in-home hospice. These facilities are in a good position to provide hospice care since they have staff available 24/7 and can work with hospice providers. It’s a seamless transition from community living to the personal care of hospice.
  • Skilled nursing homes – This is the most common place for hospice care, particularly for patients with advanced illness and needs or have transitioned from the hospital. Many of these facilities have hospice units and contract with hospice providers that work in tandem with the nursing home’s long-term care trained nurses and aides.
  • In-patient hospice facility – These are facilities that provide hospice care only and are an alternative to home or nursing hospice care. Most have private suites and some offer accommodations for family members to stay overnight or for extended periods with their loved one.
  • Respite care – A temporary caregiver is provided to give a family member or friend a break from their daily duties of caring for you.

How is Hospice Paid For?

If you have or qualify for Medicare or Medicaid insurance, hospice care is typically covered in full with no deductible or co-pay under the Medicare Hospice Benefit. The Veterans Administration also has a hospice benefit. Most private insurances cover hospice if you meet the requirements, however, there may be some out-of-pocket expenses you and your family may be required to pay.

One of the major costs you likely will be responsible for is room and board in a nursing facility. Medicare does not pay for long-term care room and board. There are some private long-term care insurances that cover some of these costs. Medicaid covers room and board, but you must meet income guidelines.

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