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 ultimate decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff members are sensitive to these concerns and are always available to discuss them with the patient and family. Once the decision is made, hospice patients are cared for by a team of physicians, nurses, social workers, certified nursing assistants, clergy, and volunteers, each providing assistance based on his or her own area of expertise. In addition, hospice provides medications, supplies and equipment related to the terminal illness.

Must the doctor call to arrange for Hospice care?

No, anyone may make the initial contact by calling the Hospice of Southern WV office at (304) 255-6404 -- a patient, a family member, a neighbor or friend, for instance. However, a physician's approval is needed for hospice care since the doctor remains involved in the participant's care plan.

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

Certainly. If a patient's condition improves and the disease or illness seems to be in remission, patients can be discharged from hospice, return to aggressive therapy, and go on about their daily lives. If needed, patients may also return to hospice at a later time.

What does the hospice admission process involve?

After receiving a referral for hospice services, one of the first things the hospice program will do is contact the patient's physician to make sure he or she agrees that hospice is appropriate. Our hospice Medical Director is available to help patients who have no physician. Once the patient is certified, hospice services will begin immediately.

Must someone be with the patient at all times?

If a patient begins hospice services in the early stages of the disease process, it's usually not necessary for someone to be with the patient all the time. Later, however, as the disease progresses, it will be necessary for someone to be present continuously. While family and friends deliver most of the care, hospice does provide volunteers to assist with errands and to provide respite care to allow primary caregivers to take needed breaks and have time away. The Doug and Lucy Bowers Hospice House in Beckley is an additional option for end-of-life care for those who do not have a caregiver.

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

It's never easy and can often be quite hard. At the end of a long, progressive illness, days and nights can be very long, lonely and scary. Hospice has staff available around the clock to consult by phone and make visits whenever appropriate. Although most of hospice care is provided in patient homes, hospice can also serve patients who live in nursing homes, personal care homes and assisted living facilities. The Bowers Hospice House may also be appropriate for someone who is no longer able to stay in their own home.

Does hospice do anything to make death come sooner?

No. Hospice neither hastens nor postpones death. The nature of dying is so unique that the goal of the hospice team is to be sensitive and responsive to the special requirements of each individual and family, providing the physical, spiritual and emotional support that is satisfactory to them. A 2007 study by the Journal of Pain and Symptom Management looked at Medicare beneficiaries with some of the most common diagnoses leading to death. The study found that patients who received hospice services lived, on average, 29 days longer than those who did not receive hospice services. This study looked at 4,493 terminally ill patients with either congestive heart failure or cancer of the breast, colon, lung, pancreas or prostate.

How does Hospice “manage pain”?

Hospice believes that emotional and spiritual pain is just as real and in need of attention as physical pain. Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and symptom relief. Hospice has a very high success rate in battling pain. Families often worry about medications preventing the patient from being able to talk, know what's happening, or from being 'themselves.' Some families even worry about addiction. It is the goal of hospice to have the patient as pain free and alert for as long as possible. By constantly consulting with the patient, their families and their physician, hospice has been very successful in reaching this goal.

Is hospice care covered by insurance, Medicare, Medicaid, etc.?

Hospice coverage is widely available. Hospice is covered by Medicare, Medicaid and most private insurance providers. If a patient is not covered by private insurance, Medicare or Medicaid, Hospice will assist the family in finding sources of coverage they may not be aware of. Hospice of Southern WV will not refuse services based on lack of coverage and families will never receive bills for hospice services related to a patient's terminal diagnosis.

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

Hospice provides continuing contact and support for caregivers and families for at least a year following the death of a loved one. Hospice also provides bereavement support groups in the four counties we serve (Raleigh, Fayette, Summers, Wyoming). The support groups are open to anyone in the community who has experienced the death of a loved one, not just to hospice participants. Families also receive monthly letters of hope and quarterly phone calls as part of our bereavement services. Caregivers or family members who are unable to attend support group meetings or who need more personal attention are encouraged to schedule a home visit.

Should I wait for a physician to raise the possibility of hospice, or should I mention it first?

Patients and families should feel free to discuss hospice care at any time with their physicians. Private and free consultation visits explaining hospice services are available to the family and/or physician at any time by calling our office at (304) 255-6404 or toll-free 800-900-6404.

Who provides Hospice services?

Professional staff of varying disciplines provides hospice care as part of a multi-faceted approach to serving individuals and their families. These professionals include: RN's, LPN's, Home Health Aides, Social Workers, Clergy, Volunteers and a Medical Director.

Is Hospice affiliated with any religious organization?

Hospice of Southern West Virginia is not an extension of any religion. While some religious organizations have started hospices across the country, they do not require patients to adhere to any particular set of beliefs. Part of Hospice of Southern WV's support system is an inter-faith network of chaplains available to patients who express the need for spiritual counsel.

If the patient is not covered by Medicare, Medicaid or some other insurance, will Hospice of Southern WV still provide care?

Yes. While Hospice of Southern WV will assist families in awareness of available coverage, we will not turn away patients who are unable to pay and will not bill families following the patient's passing. There are some instances where room and board at the Bowers Hospice House are applicable on a sliding fee schedule, but these potential fees and their circumstances are discussed with patients' families during assessment and admission. No patients are turned away from our hospice for inability to pay.

Must I have a DNR (Do Not Resuscitate) order in place to qualify for Hospice services?

No. While many patients given a limited life expectancy do not desire heroic measures in an attempt to restore life (i.e. CPR, defibrillation, paramedic or EMT intervention, or ventilator), it is not necessary to have a DNR in place before receiving Hospice of Southern WV homecare services. Patients must be a DNR only if admitted to the Bowers Hospice House facility. Hospice will counsel patients to determine their end-of-life wishes during the admissions/consultation process.