What is hospice care?

Hospice care honors the natural progression of life and strives for comfort and quality at journey’s end. Hospice care does not hasten or prolong the dying process . It takes a holistic view of patient needs at end-of-life, appreciating social and spiritual elements that contribute to a sense of well-being. It is important to understand that hospice care is about honoring life during its final and very special stage.

Care is provided by specialized multi-disciplinary teams, comprised of medical professionals, including physicians and nurses; in-home aides; social workers; chaplains; volunteers; families and friends. Each member of the team is equally important to optimizing care and may assume greater or lesser roles at any given time based on patient need.

What makes Hebrew SeniorLife Hospice Care Unique?

Our hospice staff, guided by the Rabbinic Director, understand and honor the diversity of Jewish sensibilities and spiritual perspectives around life and death. They offer guidance informed by Jewish values and traditions in harmony with each patient’s orientation. The philosophy of our hospice is rooted in the values of Hessed (loving kindness), and Kevod HaBeriyot (honoring life).

Hebrew SeniorLife Hospice Care is open to everyone regardless of religious affiliation.

Who is eligible for hospice care?

Eligibility for hospice care is based upon two government-determined criteria:

  1. The patient’s condition has been diagnosed as incurable; and
  2. Life expectancy is approximately six months or less if the illness runs its normal course.

Hospice care does not “cut off” at the end of the initial six-month period. Hospice benefits continue as long as the hospice physician continues to certify a six-month life expectancy and the patient wishes to continue hospice care.

If a patient’s terminal condition improves, he/she can be discharged from hospice and return to curative treatment, or resume daily life without any medical intervention. If need be, patients can later return to hospice care.

Where do patients receive hospice care?

With some restrictions, most hospice care is provided wherever a patient calls home — often with a family member serving as the primary caregiver. Hospice care can also be provided in some health care facilities, including licensed skilled nursing facilities, assisted living sites and dedicated hospice facilities.

How are patients referred to hospice care?

Often a physician recommends hospice care to a patient. However, it is the patient's right (or in some cases the right of the patient’s designated health care proxy) to determine when hospice is appropriate and which program suits his or her needs. Before entering a hospice, a physician must certify that a patient has been diagnosed with a terminal illness and has a life expectancy of approximately six months or less. This action is required to activate the special Medicare Benefit for hospice coverage.

What does the hospice admission process involve?

HSL Hospice Care will contact the patient’s physician to make sure that he or she agrees that hospice care is appropriate for the patient at this time. The patient or representative will be asked to sign consent and insurance forms. These are similar to the forms a patient signs when he/she enters a hospital. The hospice election form says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the accompanying hospice services available. The form Medicare patients sign also describes how electing the Medicare hospice benefit affects other Medicare coverage.

What can a patient expect from hospice care?

Routine Home Care

The patient is in his/her home setting and symptoms are under good control with periodic hospice visits. Most hospice patients at any given time are at this level of care, but the hospice interdisciplinary team is constantly monitoring and reassessing the patient’s needs and will recommend other levels of care if needed to achieve optimal symptom management.

General Inpatient (GIP) Care

If the patient experiences a symptom crisis that cannot be effectively managed at home, it might be necessary to transfer the patient to an inpatient setting (e.g. an acute care hospital or skilled nursing facility) where round-the-clock nursing care can be provided.

Continuous Care

Continuous care designates a short period—usually a day or less—when the continuing presence of the hospice staff is required in the home, as determined by the hospice.

Respite Care

Caring for a terminally ill loved one is a very loving act, but it can also be emotionally and physically exhausting. The Respite benefit covers a brief stay in an inpatient setting such as a nursing home where the patient can receive the necessary care and the primary caregiver can get some much-needed rest.

How is hospice paid for?

Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice will work with the person and their family to ensure needed services can be provided.

Why is Hebrew SeniorLife adding hospice to its continuum of care?

For more than a century Hebrew SeniorLife has been caring for seniors in the Greater Boston area. That experience has fostered a profound sensitivity to the special needs of those we serve both in our local housing communities and the broader community and their families. Providing end-of-life care that respects Jewish values and cultural diversity is an imperative to fulfilling our mission.