It's appropriate to discuss all care options, including Hospice, at any time during a life-limiting illness. By law, the decision belongs to the patient. Though some people view Hospice as the equivalent of giving up, most Hospice families say that being in Hospice gave them precious quality time with their loved ones.

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Who should raise the possibility of Hospice care ~ a doctor, the family, the patient?

You and your family should feel free to discuss Hospice care at any time with your physician, other health care professionals, clergy or friends.

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What if our physician doesn't know about hospice?

Most physicians know about Hospice. If your physician wants more information about Hospice, it is available from Calvert Hospice, (410) 535-0892, the Hospice Network of Maryland, (410) 729-4571, or the National Hospice Help line, 1-800-658-8898.

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Can a Hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If the patient?s condition improves and the disease seems to be in remission, patients can be discharged from Hospice and return to aggressive therapy or go on about their daily life. If a discharged patient should later need to return to Hospice care, Hospice will be available at that time.

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What does the Hospice admission process involve?

Hospice will first contact the patient's physician to make sure he or she agrees that Hospice care is appropriate for this patient at this time. Then a Hospice nurse or social worker will visit the patient and family.

The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The Hospice Informed Consent says that the patient understands that care is palliative ~ aimed at pain relief and symptom control ~ rather than curative. Services available will be described. The election form Medicare patients sign also tells how electing the Medicare Hospice benefit affects other Medicare coverage for terminal illness.

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Is there any special equipment or changes I have to make in my house before Hospice care begins?

Calvert Hospice staff will assess your needs, make recommendations, and help make arrangements to obtain any necessary equipment. The need for equipment may be minimal at first, but may increase over time. In general, Calvert Hospice staff will assist in any way they can to make home care as convenient, comfortable and safe as possible.

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How many family members or friends does it take to care for a patient at home?

There?s no set number. An individualized care plan will be prepared that will address, among other things, the amount of care giving needed in your situation. Hospice staff visits regularly and are always accessible to answer medical questions and provide support.

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Must someone be with the patient at all times?

This will depend upon how ill the patient is when he or she is admitted to Hospice. Because one of a patient's most common fears is the fear of dying alone, Hospice generally recommends that someone be home with the patient as the end of life nears.

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How difficult is caring for a dying loved one at home?

It?s never easy emotionally and sometimes can also be physically draining to care for a terminally ill loved one. Nights especially can be very long, lonely and scary near the end of a long, progressive illness. So, Calvert Hospice has a nurse available around the clock to consult with the family and make night visits if the need arises.

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What specific assistance does Hospice provide home-based patients?

Calvert Hospice provides a team of nurses, social workers, counselors, home health aides, clergy, therapists, and volunteers to care for each patient. Each team member provides assistance based on his or her area of expertise. In addition, Calvert Hospice helps provide medications, supplies, equipment, hospital services, and additional helpers in the home, if and when needed.

While most direct patient care is provided by family and friends, Calvert Hospice volunteers are available to assist with errands and to provide a break and time away for caregivers.

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Does Calvert Hospice do anything to make death come sooner?

Calvert Hospice does nothing either to speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, so Hospice provides its presence and specialized knowledge during the dying process.

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Is caring for the patient at home the only place Hospice care can be delivered?

No. Although 95% of Calvert Hospice patients are at home, care is provided for patients living in retirement communities, assisted living facilities and nursing homes.

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How does hospice "manage pain?"

Calvert Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists are available to assist patients to be as mobile and self-sufficient as possible.

Calvert Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses each. Trained counselors and members of the clergy are available to assist family members as well as patients.

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What is hospice's success rate in battling pain?

Very high. Using some combination of medications, counseling and therapies, most patients can have their pain managed at an acceptable level.

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Will medication prevent the patient from being able to talk or know what's happening?

Usually not. It is the goal of Hospice to allow the patient to be free of pain but also alert. By constantly consulting with the patient, Calvert Hospice has been generally successful in reaching this goal.

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Is hospice affiliated with any religious organization?

Calvert Hospice is an independent, non-profit organization. It is not affiliated with any church or religion.

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Is hospice care covered by insurance?

Hospice is covered by Medicare, Medicaid and most private insurance policies. To be sure about your specific policy, check with your health insurance provider.

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If the patient is eligible for Medicare, will there be any additional expenses to be paid?

Medicare covers all services and supplies for the hospice patient related to their terminal diagnosis.

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If the patient is not covered by Medicare or any other health insurance,will hospice still provide care?

Calvert Hospice provides care regardless of a patient?s ability to pay. Calvert Hospice staff will assist families in finding out whether the patient is eligible for any coverage he or she may not be aware of, but care will be provided.

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Does hospice provide any help to the family after the patient dies?

Hospice provides continuing contact and support for family and friends for a minimum of 13 months following the death of a loved one. Calvert Hospice also sponsors bereavement groups and individual support for anyone in the community who is grieving the death of a loved one.

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