Dispelling Hospice Myths: 10 Truths the Public Should Know About Hospice Care

By Mary K. Spengler

While more than 1.7 million Americans die each year in hospice care, many other Americans eligible for these services did not elect them because of the stigma, fears and misinformation linked to end-of-life care.

Conversely, hospices nationwide report consistently that patients and families wish they elected hospice sooner.

To help make an informed decision about end-of-life care, below is a list of hospice myths – debunked and dispelled.

1.Myth: Hospice is a place.

Reality: Hospice care usually takes place in the comfort of an individual’s home, but can be provided in any environment in which a person lives, in a private residence, a skilled nursing facility or an assisted living facility.

2.Myth: Hospice is only for cancer patients.

Reality: More than 50 percent of hospice patients nationwide have a diagnosis other than cancer. Hospice cares for people with any serious or life-limiting illness, including heart disease, cancer, Lou Gehrig’s disease, cirrhosis, emphysema, kidney disease, AIDS and Alzheimer’s disease, among others.

3.Myth: Hospice is just for the patient.

Reality: Hospice focuses on comfort, dignity and emotional support of the patient as well as family members and caregivers. Hospice of Westchester offers a wide range of bereavement services and support for family members for up to 13 months following the loss of a loved one.

4.Myth: Once you choose hospice care, there’s no going back to traditional medical treatment.

Reality: Patients are free to leave a hospice program at any time for any reason without penalty. If a patient’s condition improves, he or she can be discharged from hospice and return to aggressive, curative measures, if so desired. If a discharged patient wants to return to hospice care, Medicare, Medicaid and most private insurance companies and heath management organizations (HMOs) will allow readmission if he or she meets the medical eligibility criteria.

5.Myth: If you choose hospice care, you won’t get other medical care and can no longer receive care from a primary care physician.

Reality: While the hospice team will provide all aspects of care for the illness that qualifies you for hospice services, you are still free to seek treatment for unrelated illnesses or conditions. For example, if you are receiving hospice care for heart disease, you can still get treatment for a broken bone. Hospice also works closely with your primary physician and considers the continuation of the patient-physician relationship to be the highest priority.

6.Myth: After six months, patients are no longer eligible to receive hospice care through Medicare and other insurance.

Reality: According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, Medicare, Medicaid and many other private and commercial insurance providers will continue to cover hospice services as long as the patient shows a physical decline and is recertified by the hospice medical director due to the decline of the patient.

7.Myth: All hospices are the same.

Reality: All licensed hospice programs must provide certain services, but the range of support services and programs may differ. Like other medical care providers, the business models differ. Additionally, hospice programs and operating styles may vary from state to state depending on laws and regulations, and some programs are nonprofit while other hospices are for-profit. Hospice of Westchester is a nonprofit, tax-exempt organization that provides regular hospice services along with unique offerings. Its Complementary Care program, which is available at no cost to patients, provides massage therapy, music therapy, reflexology, art therapy and a compassionate doula. Other hospices may not offer these programs or rather variations of these services.

8.Myth: It’s the doctor’s responsibility to bring up hospice.

Reality: While it is the physician’s responsibility to determine whether a patient meets the medical eligibility criteria to receive hospice services, it is appropriate for the patient or caregiver to initiate the discussion with their primary physician and call hospice for information.

9.Myth: To be eligible for hospice care, a patient must already be bedridden.

Reality: Hospice care is appropriate at the time of the terminal prognosis, as long as the patient meets the medical eligibility requirement, regardless of the patient’s physical condition. Many of the patients served through hospice continue to live with the best quality of life possible.

10.Myth: Hospice care is expensive.

Reality: Most people over 65 may have Medicare. Medicare is not the only insurance that provides coverage for hospice care. Medicare covers hospice services and there is little out-of-pocket expense. However, most private plans, HMOs and other healthcare organizations include hospice care as a benefit. Additionally, through community contributions, memorial donations and foundation gifts, many hospice programs are available to those who lack insurance.

For more information, visit www.hospiceofwestchester.org.

Mary K. Spengler is CEO of Hospice of Westchester