Frequently Asked Questions

What is Hospice?

Hospice is primarily a concept of care, rather than a specific place. HOSPICE OF THE VALLEYS  provides medical care that focuses on relief of symptoms that cause suffering (physical, emotional, and spiritual pain, shortness of breath, nausea, etc.) and improvement of quality of life, when medicine cannot otherwise provide a cure or comfort cannot be achieved. We strive to offer comfort through aggressive treatment of physical and emotional symptoms, while providing care and support to the patient, family and friends (our "unit of care") reflecting love, warmth, empathy and compassion.

Hospice is about respecting the dignity of human life and making every life as meaningful as possible, which greatly enhances the quality of life for our patients.

HOSPICE OF THE VALLEYS  provides services wherever and whenever needed. Our goal is to keep patients in secure and familiar surroundings, whether that is a family residence, assisted living facility or skilled nursing facility. When we cannot control symptoms in these residential settings, we provide inpatient care until symptoms are well managed.

A team-oriented approach is utilized by HOSPICE OF THE VALLEYS  to care for both the patient and loved ones. We personally tailor the skills of physicians, nurses, home health aids, social workers, chaplains, and volunteers to the needs and wishes of our patients.

Who is Eligible For Hospice?

Hospice care is available to anyone, regardless of age, ethnicity, race, religion, gender, socio-economic status, sexual orientation, or illness. Hospice patients do not have to be bed-bound or even home-bound. Two physicians must certify that a patient has a disease process that is not curable and would lead to a life expectancy of six months or less if it follows an expected course. However, some patients live longer, for months and even years. As long as a physician continues to certify that the life expectancy is 6 months or less, patients can be recertified for hospice care every 60 days.
HOSPICE OF THE VALLEYS  provides services to meet the physical, social, emotional, and spiritual needs of the patient and family. An interdisciplinary team of specially trained professionals make regular visits to assess the patient and provide care and other services.
Our interdisciplinary team works 24 hours a day, 7 days a week to ensure the coordination of quality care. In addition, hospice provides durable medical equipment, medical supplies, medications, therapies, and wound care.

When should a decision about entering a hospice program be made and who should make it?

At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice.  By law, the decision belongs to the patient.  Understandably, most people are uncomfortable with the idea of stopping an all-out effort to "beat" their disease.  Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.  Rather than waiting for the physician to raise the possibility of hospice, the patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professional, clergy or friends.

What should I do to get Hospice services?

After the decision to receive care from a hospice, the hospice will contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time.  (HOV will make medical staff available to help patients who have no physician.)  The patient will also be asked to sign a consent form.  This is similar to the form patients sign when they enter a hospital.  The hospice election form says that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative.  It also outlines the services available.  The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.

Will my doctor follow me ?

While every hospice has a medical director to assist the interdisciplinary team, your physician will be included in every decision regarding your hospice care. The hospice nurse will be in continual contact with your physician, indicating changes in your condition, and asking for medications that will keep you comfortable.

How is hospice paid for?

Hospice coverage is widely available. It is provided by Medicare nationwide, by MediCal, and by most private insurance providers. To be sure of coverage, families should check with their employer or health insurance provider. Medicare and MediCal covers all services and supplies for the hospice patient related to the terminal illness. In some hospices, the patient may be required to pay a 5% or $5 "co-payment" on medication and a 5% co-payment for respite care. You should find out about any co-payment when selecting a hospice. HOV does not collect this co-payment.

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

Hospice care is available wherever the patient lives, i.e., at home, at a board and care, at an assisted living facility or at a skilled nursing facility. The members of the hospice team visits with and provides care for the patient in these facilities.

How does Hospice manage pain?

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses each. Hospice nurses and doctors are up-to-date on the latest medication and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self-sufficient as they wish. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort that is acceptable to them.

Does Hospice do anything to make death come sooner?

Hospice does nothing to hasten or postpone the dying process. We do not engage in physician assisted suicide. We assist the patient to be comfortable, and pain free until the moment the patient chooses to let go of life and die.

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

HOSPICE OF THE VALLEYS provides continuing contact and support for caregivers for 13 months following the death of a loved one. Our hospice also sponsors bereavement groups and support for anyone in the community who has experienced a death of a family member, friend, or similar losses.

Can I choose a hospice?

Yes, if you receive your medical coverage from Medicare or MediCal. Even if the HMO or managed care program that you receive care from has a contractual arrangement with one hospice, you can still receive care from a hospice of your choice. Because you elect hospice benefits, the hospice is paid directly by Medicare and MediCal. Your other health needs will be covered by your HMO, but any need arising from the terminal illness will be cared for by hospice. Remember...

Not all hospices are created equal

Here are some questions to ask when considering which hospice program to use.

1. Is it a for-profit or not-for-profit hospice?
   Of the twelve hospices licensed to serve Riverside County, eight are for-profit hospice. For-profit programs pay stock dividends to shareholders, or the owner of the corporation. They pay bonuses to staff for getting referrals. They will hire one person to do more than one full time job, so that the standards are met without regard to the quality of the service provided to the patient and or family. How are they licensed - a hospice or a home health agency?



2. If it is a not-for-profit hospice, how do they use the money that remains at the end of the year?
   Some of the not-for-profit programs use the money they make caring for hospice patients to cover expenses in other areas of their programs. For example, home health agencies many times run a deficit in the homecare section of their program. Money made on hospice patients is used to cover this deficit.



3. What is the ratio of patients to staff?
   National Hospice and Palliative Care Organization has standards which have been established for quality hospice care.

   1 Nurse for every 8-12 patients
   1 Social Worker for every 20-30 patients
   1 chaplain for every 60 patients
   1 Bereavement Coordinator for every 200-300 deaths in a year

4. Do they have volunteers and how are volunteers utilized?
   Federal and state laws indicate that volunteers are to be used and that 5% of the paid staff hours need to be matched by volunteer hours.
   Volunteers may be utilized in the following ways:

   Patient Care - respite and support to family members by coming to the home for 4 hours a week
   Office Volunteers - filing, receptionist, mailings, etc.
   Administrative - serving on the Board of Directors, committees, etc.



5. What type of bereavement program do they offer to the family after the death of the patient?
   By law, Hospice must provide 13 months of bereavement support to family members.
   

   Who supervises the bereavement program?
   Is there a separate bereavement coordinator or is it handled by another member of the team?
   Are there bereavement groups?
   Who may attend?
   How often do they meet?
   Do they provide regular mailings, follow-up telephone calls, etc.
   

6. Can I transfer from one hospice program to another?
   Yes, you can. Federal and state regulations allow for a patient to transfer from one certified program to another once each benefit period. This provision was written into the regulations to allow people to increase the choices that they have regarding hospice care. It allows for people to move from their own home to be closer to their children and still receive care. It allows for patients and families who are not satisfied with the services that are provided by one hospice to choose another program.