According to studies, if given a chance, seven in ten Americans would prefer to pass peacefully in the comfort of their home. However, not everyone has the opportunity to choose their own end-of-life care plan or have their last wishes honored. 

Fortunately, it is still not too late for you or your loved one to prioritize comfort rather than prolonging life through drugs and hospitalization. You can start discussing the possibility of hospice care to improve your loved one’s quality of life right away.

But what is hospice care at home, and what does this care option entail? Keep on reading below as we go into detail about everything you need to know about hospice.

What is Hospice?

Hospice care refers to a unique care option given to individuals with a life-limiting condition or terminal illness. Doctors can also recommend hospice to individuals when:

  • Their bodies do not respond to the treatments administered to cure their disease. 
  • They have a downward prognosis despite medications.
  • They want to forgo treatments and get relief from their symptoms instead. This way, they can focus on enjoying their last remaining days the way they want to.

Hospice care also aims to provide support to patients by relieving their pain and managing other symptoms so they can live as comfortably as possible.

Moreover, this type of care provides a range of holistic services so patients can achieve the highest quality of life possible. This can include honoring a patient’s last wishes so they can pass on in peace and with dignity.

More importantly, hospice does not focus on treating the patient’s illness itself. Instead, hospice care’s focal point is to provide you or your loved one a comfortable and peaceful end-of-life experience. 

care provider talking to a sitting senior on hospice care

What Is Hospice Care At Home?

At Cardinal Hospice, we offer hospice care at home in Michigan and the surrounding areas. Contrary to popular belief, the term hospice does not refer to a place or an institution. Rather, it pertains to a care plan that prioritizes one’s comfort and happiness. This means that hospice services can be given anywhere, depending on the patient’s condition and needs.

Typically, hospice agencies provide hospice care in the patient’s own home. So, it means that it can be in your or your loved one’s nursing home, assisted living, or residential house. Care personnel usually provide hospice services around the clock. However, it will still depend on what program you or your family choose.

How Does In-Home Hospice Work?

Hospice care begins once you or your loved one enters a specific hospice program. Then, a care provider will visit your residential setting to evaluate what level of care the would-be hospice patient will require. 

Based on the health assessment, your hospice team will decide how often they will do a home visit to provide care and support. They can also schedule nurse visits, spiritual counselors, and therapist visitations as needed by the patient.

Sometimes, a hospice team member may designate a caregiver to stay with you to provide around-the-clock supervision and assistance. Additionally, you or your loved ones can contact your hospice provider in times of crisis. An on-call nurse, doctor, or healthcare professional is always there to respond during emergencies. 

Who Provides At-Home Hospice Care?

Hospice care agencies consist of a team of healthcare professionals and care aides trained to provide the highest quality of care services. A hospice care team usually consists of the following:

  • Registered nurse
  • Medical director
  • Certified hospice and home health aides
  • Social workers
  • Chaplains
  • Bereavement counselors
  • Volunteers

These caring staff members will be responsible for providing different kinds of assistance一from regular health reports and visitations to spiritual services. 

Besides the hospice team, the patient should also have a primary caregiver to take care of their daily physical care. It can be a close family member since the primary caregiver is also responsible for making important decisions for the patient. If no one is available, your hospice team may recommend a caregiver or a volunteer to assume this position.

In some cases, the patient’s primary care doctor may also become involved in providing medical and health care. But of course, this will all depend on the patient’s health condition and medical requirements. 

Related: How to Avoid Hospice Care Nightmares?

What Hospice Services Are Provided At Home? 

Hospice services can vary depending on the type of program you choose for yourself or a loved one. But generally, the usual services provided by most hospice care agencies include:

  • 24/7 supervision, if needed, from one of the members of your hospice team if there’s no family caregiver available
  • Caregivers and aides that can assist with activities of daily living, such as bathing, dressing, grooming, and cleaning
  • Medicine administration for pain relief and symptoms
  • Counseling services for the hospice patient and their family
  • Religious and spiritual services for patients and loved ones
  • Physical, occupational, and speech therapy
  • Healthy meals with dietary counseling
  • Bereavement care and grief counseling for family members
  • Access to medical supplies (e.g., catheter) and equipment if need be
  • Volunteer services to take care of errands or offer companionship

Furthermore, hospice patients also get access to an on-call nurse 24 hours a day. Plus, the hospice team will also develop an individualized care plan for you or your loved one. This will determine their visitation schedules and what kind of services they will provide daily. 

Related: The Value of Hospice Care at Home (Complete List of Benefits)

Who Is Eligible For Hospice Care? 

According to Medicare, only a primary care doctor or a hospice medical director can certify or proclaim a patient eligible for hospice care. Physicians use a set of rules to identify if a patient qualifies for hospice care. Some of these qualifications include:

  • If a person has a terminal or incurable illness and has a life expectancy of fewer than six months
  • A PPS (palliative performance scale) score of less than 70% for cancer patients while below 50% for patients with other types of illness
  • A patient experiences drastic changes in their nutritional status (e.g., sudden drop in body weight in the last 4 to 6 months)
  • A worsening medical condition for the past 4 to 6 months. This can be determined if the patient shows at least one of the following:
    • The patient has had more than three hospitalizations in the last 4 to 6 months.
    • The patient was observed to have a decrease in physical ability or mental cognition.
    • The patient needs assistance in doing three of the six activities of daily living.

These rules can help doctors determine if a patient’s condition qualifies for hospice care services. But of course, the decision should still be discussed thoroughly by the would-be patient, their family, and primary care physician.

Here are 6 signs that will tell you if you should consider hospice care for your loved ones.

care provider helping a senior use her walker while in hospice care at home

When Should Hospice Start?

Hospice care will only become an option if a person has an incurable illness and if death is expected within six months. Furthermore, it should only start once their doctor recommends it and once it has been discussed by the patient and their loved ones. 

However, many people seek hospice too late, thus not reaping the full benefits of this end-of-life care plan. Although a large majority of the public has a positive view of hospice, there are still a few out there who view it as “giving up” or “accepting death.”

Furthermore, not all physicians bring up the option of hospice care to terminally ill patients. As a result, people who would have benefited from it won’t be able to start hospice care soon enough.

What Are The 4 Levels of Hospice Care

Typically, hospice care programs have four levels of care. The type of care a patient will get entirely depends on their current medical condition and needs. Sometimes, a hospice patient can experience all four while others may only require one specific care option throughout their hospice stay. 

Routine Home Care 

Routine home care is similar to that of in-home hospice care. It can be provided at the patient’s residence, wherever that may be. This type of care focuses on improving one’s comfort and quality of life by providing services such as:

  • Basic medical care, like pain management
  • Assistance with daily activities, such as eating and bathing
  • Dietary and nutritional services
  • An emotional and spiritual-focused counseling session for the patient and their family
  • Palliative physical therapy

Services under routine home care will be provided on an “as needed” basis. This means that the hospice care team would have an intermittent schedule in visiting and caring for the patient.

Continuous Home Care

Continuous home care refers to a set of short-term services provided during specific periods of medical crisis. A good example is when a patient’s symptoms suddenly become severe, requiring 24/7 supervision and medical care. 

During such crises, a team of nurses or hospice aides will be responsible for the hands-on care and monitoring of the patient until their condition becomes stable. Some symptoms that might require a patient’s temporary transfer from routine to continuous home care include:

  • Severe pain
  • Continuous nausea and vomiting
  • Acute respiratory distress
  • Bleeding
  • Unbearable agitation and restlessness

Inpatient Care

The hospice team may resort to inpatient care if the patient’s condition can no longer be managed despite continuous home care. This type of hospice care happens in the hospital, hospice facility, or long-term care facility. 

The primary goal of inpatient hospice care is to relieve the patient from any pain and control other symptoms so they can return home.

Respite Care

Respite care greatly differs from the other levels of hospice care as it mainly involves the primary or family caregiver rather than the patient. 

In respite care, a hospice patient may be temporarily moved to another facility to give their caregiver a much-needed break from their duties. The hospice patient may temporarily stay in another hospice unit for at least 24 hours to five days.

This type of care proves to be especially helpful for home hospice patients whose family member serves as their primary caregiver.

senior woman at talking to a nurse hospice care at home

Inpatient Hospice Vs. Home Hospice 

As discussed above, both inpatient and home care falls under the four levels of hospice care. However, their stark difference lies in the location where the care is provided and the scope of services. 

In routine home hospice, the patient receives care, assistance, and other services in their home or residential facility they currently live in (e.g., assisted living). Furthermore, the services provided here focus more on improving comfort and quality of life.

On the other hand, inpatient hospice happens in a medical facility (e.g., hospice unit or hospital) to immediately address the patient’s medical needs. This type of care only occurs when the patient has severe symptoms, which cannot be controlled anymore with continuous home care alone.

Hospice Care Vs. Comfort Care 

According to the National Institute of Aging, comfort care refers to an end-of-life care plan that relieves suffering and improves the quality of life of a dying person. 

Moreover, its main focus is to eliminate discomfort so the patient can enjoy their remaining days surrounded by loved ones.

With that definition, it’s safe to say that it’s much like hospice care. However, their only difference lies in where the care is provided. 

Typically, a care team provides comfort care in a treatment facility or institution. But, more often than not, there’s also the constant presence of nurses, doctors, and trained caregivers to facilitate treatment.

In hospice care, the majority of the supportive care and assistance gets provided at home by the family caregiver. A hospice care team would visit and provide other services as needed, such as therapy, counseling, and spiritual sessions.

Related: Surprising Differences Between Hospice vs. Comfort Care

Hospice Care Vs. Palliative Care 

Hospice and palliative care are both considered types of comfort care. Both forms also provide expert medical care, pain management, and emotional and spiritual support to hospice patients and their families. 

However, these two differ regarding their primary objective, treatment services, location, and healthcare team.

For one, hospice care’s services are tailored to honor the patient’s wishes while focusing on their quality of life. Instead of trying to cure the illness itself, all medical efforts get focused on relieving symptoms to bring the highest level of comfort to the patient. 

On the other hand, palliative care services focus on treating the illness while also addressing pain management and the emotional and spiritual needs of the hospice patient. Some of their other differences include:

  • Start of care – palliative care starts after the diagnosis, while hospice only begins when all treatment options fail to improve the patient’s condition.
  • Services – almost the same services apply for both types of care. However, palliative services have a much broader treatment and medical benefits given that it prioritizes on curing the disease.
  • Location – hospice care mostly happens in the patient’s home, while palliative care patients spend most of their time in a facility (e.g., hospital) that administers their treatment.

How Is Hospice Paid For? 

Here’s how you or your loved one can pay for hospice services:

  • Government Programs – both Medicare and Medicaid can shoulder your hospice care expenses provided that you meet their qualifications.
  • Veteran’s Benefits – the Veterans Health Administration also provides hospice care benefits similar to Medicare.
  • Health Insurance – your private insurance plan can also cover some of your hospice care costs. It is best to check with them and see if your health plan covers its expenses.

If you are uninsured, some hospice agencies offer care without charge or at a lower rate, depending on your ability to pay. So it’s best to check your chosen hospice agency or facility if they provide such financial assistance. 

FAQs About Hospice Care

A graph that shows public prioritizes pain and stress relief over prolonging life

How long does a person live after being put on hospice? 

On average, it is 89.6 days, according to the National Hospice and Palliative Care Organization.

Is hospice for the dying only? 

No. It is a care option that prioritizes your or your loved one’s wishes for comfort and support without neglecting physical health.

How long does a hospice nurse stay at your house? 

It depends on your or your loved one’s medical needs and condition. However, they are available on-call 24 hours a day. 

Does hospice cover 24-hour care at home? 

Yes. Hospice care provides 24-hour care at home if deemed necessary based on the patient’s needs and condition.

woman hugging a cancer patient on hospice care

Where To Find the Best Hospice Care at Home Service in Michigan? 

At Cardinal Hospice, we care for your well-being. We believe that compassionate care and holistic support are vital ingredients towards a quality life. Thus, we strive hard to provide the best life care and assistance that you and your loved ones deserve. We have all the best qualities you should look for in a hospice care service provider.

If you or someone you love would benefit from hospice care at home in Michigan, then you can visit one of our convenient locations at Bay City and Oxford, Michigan. Our skilled hospice team is trained to provide the four levels of hospice care and services to you and your family. This includes:

Contact us now so you can learn more about what hospice care at home entails and the comprehensive range of services it provides. You can also meet in person with our qualified caregivers so they can assist you every step of the way.