It is only natural to have questions at a time when you are considering support for a serious illness or care at the end of life. A list of some of our most common questions is provided for your reference below.
|Hospice and Treatment Plus (Palliative Care)||Patient Condition||Beravement|
|Place of Residence||Medication and Equipment||Payment/Insurance|
Hospice and Treatment Plus (formerly known as Palliative Care)
Q: Is hospice a place?
Hospice is a specialized form of health care and is not a place. Hospice care provides a special team approach to support the physical, emotional and spiritual needs of people who are in the last six months of life and are no longer receiving curative treatment.
Hospice care can be provided wherever a patient resides, whether in a private home, nursing home, community-based residential facility (CBRF), residential care apartment complex (RCAC) or the Jack and Engrid Meng Residence (Unity's home-like hospice residence that features 12 private rooms).
Q: Is there a distinction between hospice and treatment plus?
Yes. Hospice care and treatment plus both are specialties that provide comfort care, relief of suffering and improved quality of life; however, hospice care is available to individuals with a life expectancy of six months or less who are not seeking curative treatment, while treatment plus is offered to all individuals during the course of an illness, regardless of whether or not they are seeking curative treatment.
Q: Is hospice the same as home health nursing?
No. Home health nursing is designed for short-term, rehabilitative interventions for home-bound individuals with a skilled medical need; whereas, hospice care addresses continuity of care during the last six months of a patient's life and does not require the patient to be home-bound. Hospice care also provides an interdisciplinary team including a nurse, social worker, certified nursing assistant, chaplain, volunteers, grief counselor and medical director.
Q: When should patients and families consider hospice care or treatment plus?
After an individual is diagnosed with a life-limiting illness, the patient and family should evaluate whether or not hospice care or treatment plus is appropriate. Unity's staff would be happy to meet with you and explain care choices available to support your needs.
Q: What does the admission process involve?
Upon placing a call to Unity, a referral nurse will speak with you. You will be asked various questions, such as the name and contact information of the prospective patient, prognosis, physician name, etc., to aid in gathering information for further discussion. A social worker and/or nurse from Unity will then schedule a meeting with the prospective patient and family to discuss care needs and how Unity can help. Our goal is to make this contact within 12 to 24 hours of receiving the referral. Throughout the admission process, Unity staff is happy to answer your questions and guide any necessary paperwork. Individuals are at no time obligated to sign onto a Unity program, and strict confidentiality is honored at all times.
Q: Does hospice do anything to hasten death?
Hospice care neither advances nor suspends the dying process. Rather, hospice care focuses on patient comfort and offers specialized knowledge at the end of life.
Q: How is hospice different from other medical care?
Hospice care takes a holistic approach, providing physical, emotional and spiritual care to the patient and family with an interdisciplinary team approach. Care teams include physicians, nurses, social workers, chaplains, grief counselors and volunteers. The main focus of care is to control the patient's pain and symptoms and provide comfort.
Q: How is Unity different from other area care providers?
Unity has been providing end-of-life care to the families of Northeast Wisconsin for over 30 years, longer than any other hospice-care organization in Wisconsin. In 2002, Unity began offering treatement plus (formerly known as palliative care) to the community. As the only locally-owned hospice organization offering a free-standing treatment plus program, Unity provides holistic physical, emotional and spiritual care to all patients diagnosed with a life-limiting illness. The largest not-for-profit hospice care and treatment plus organization in Northeast Wisconsin, Unity is a partnership of its three founders: Bellin Health, St. Mary's Hospital Medical Center and St. Vincent Hospital.
Q: How do patients and families rate the care Unity provides compared to that of other providers?
As described in its mission, Unity's goal is to provide dignity, comfort and self-determination to all individuals coping with a life-limiting illness or the issues of grief and loss. Unity participates in a nationwide family evaluation survey created by the National Hospice and Palliative Care Organization (NHPCO) and has implemented additional survey tools to aid in measuring our services.
Historically, caregivers responding to the surveys have rated Unity at or above the state and/or national averages for areas such as treating patients with respect, coordination of care and emotional support of family during care and after the loss of a loved one. As a result, virtually every family who has responded to the surveys has stated they would recommend Unity's services to others.
Unity will continue to listen to both the needs of our patients and their families. We consider this a priority as well as the right thing to do.
Q: Do patients have to leave their homes to receive hospice care or treatment plus?
No. Most patients, as long as they are able, choose to stay in their homes to receive hospice care or treatment plus. Hospice care can be provided to patients regardless of their residence. This includes private homes, nursing homes, community-based residential facilities (CBRFs), residential care apartment complexes (RCACs) or the Jack and Engrid Meng Residence (Unity's hospice residence). Treatment plus patients may receive care in their private homes, CBRFs or RCACs. Both hospice care and treatment plus continue to support patients who may need hospitalization while on the program.
Q: What would be the reasons for using both hospice and nursing home care?
Hospice care is not meant to replace nursing home or assisted living facility care. Hospice care is an approach to medical care that can be provided in any facility, including nursing homes and assisted living facilities. Unity staff works with the staff of nursing homes and assisted living facilities, discussing and adjusting the patient's plan of care to ensure continuity and effectiveness of care. Typically, when hospice care is provided in combination with nursing home or assisted living care, the facility would provide custodial care, while Unity's programs cover all the same care services that would be provided in a patient's private home.
Q: What if our physician doesn't know about Unity?
If your physician would like more information, we would be happy to supply additional literature or meet with him/her as needed. Please contact Unity at 920.338.1111 or 800.990.9249.
Q: Should patients wait for their physicians to raise the possibility of hospice care or treatment plus, or should they raise it first?
Although physicians and other health care professionals refer many patients to our programs, we also receive referrals from the patients themselves, family members, friends and clergy. A simple phone call to the Unity office at 920.338.1111 or 800.990.9249 can answer your questions and begin the process.
Q: Can patients keep their personal physicians while under Unity's care?
Yes. Unity's special team approach to hospice care and treatment plus involves individuals who support the physical, emotional and spiritual care of our patients. The patient's attending physician is welcome to serve as part of this team.
Q: I've heard that hospice care is only for cancer patients. Is that true?
Hospice care is for all people who have been diagnosed with a life-limiting illness with a prognosis of six months or less and who are no longer receiving curative treatment. Unity's team has experience caring for people of all ages with a variety of diagnoses including, but not limited to: cancer, heart disease, debility, dementia, Alzheimer's disease, lung disease, stroke or coma, kidney disease, motor neuron diseases, liver disease, and HIV/AIDS.
Q: Doesn't signing onto hospice mean my loved one is giving up?
Choosing to use hospice care means acknowledging that terminal diseases in their advanced stages most often cannot be cured. The holistic approach to care in hospice–physical, emotional and spiritual care–means providing patients with comfort and dignity as they approach the end of their lives. We seek to provide comfort care by controlling symptoms, which allows individuals to make the most of each day.
Q: What are the different levels of hospice care?
1. Routine home care is provided to all patients within their place of residence for as long as they continue to meet their hospice admission criteria.
2. General inpatient care is provided at an inpatient facility or hospital for patients who require skilled nursing care due to an acute exacerbation of symptoms.
3. Respite care is a temporary transfer of a patient from home to a nursing home, or, in special circumstances a hospital, for three to five days to provide caregivers a break from their duties.
4. Continuous care is provided at the patient's residence during a short-term, temporary period of crisis.
Q: What if a patient chooses hospice care and then lives more than six months?
In determining eligibility for hospice-care benefits, a physician must declare a patient's prognosis to be six months or less, if the disease or condition would run its regular course. There is no way for a physician to know someone's exact life expectancy. Hospice care will typically continue with coverage through Medicare and other insurance providers if the disease continues to show a limited life expectancy.
Q: What if the patient's condition improves?
Patients under hospice care will sometimes see signs of improvement in their health. Hospice care is a choice. As such, patients can choose to leave the hospice program and even seek treatment, if desired. In this case, treatment plus may be an appropriate choice for the patient to continue to receive in-home care. If the patient's condition again worsens, making them eligible for hospice care, they can re-elect the hospice benefit.
Q: Is there any special equipment or are there changes needed in a patient's home before care begins?
Hospice care and treatment plus are philosophies of care. They do not necessarily require any changes to a patient's living arrangements. Unity staff will work with the patient and family to guide them in recommended changes, equipment needs, etc., and will coordinate obtaining what is necessary.
Q: Will a patient's medication be continued once they begin receiving hospice services?
A patient's medication continues to be administered during hospice services. If and when the medical condition necessitates a change in medication or a medication type (i.e. pills, liquids, etc.), the Unity team will consult with the patient, family and physician.
Q: Will medications prevent the patient from being able to talk or know what is happening?
No. Unity works with the patient to adjust medications to keep the patient comfortable.
Q: Does a patient need to agree to a DNR order to be admitted to the hospice program?
Unity does not require a patient to agree to a DNR (do-not-resuscitate) order. Patients and their families/caregivers are counseled and educated, upon admission and as needed, regarding the hospice philosophy, and are given information regarding Advance Directives. A patient's Advance Directives and resuscitation status are documented in the medical record.
Q: How many family members or friends does it take to care for a patient at home?
The number of caregivers needed differs depending on the patient's individual needs. Upon signing onto the hospice care or treatment plus program, Unity staff will develop a plan of care for the patient, outlining the caregiver needs. While Unity staff will make regular visits to the patient, they are not with the patient at all times. Unity staff will teach caregivers and family members how to care for the patient on a routine basis, help patients locate appropriate in-home services, if desired, and help supplement caregiving needs with trained volunteers, where necessary.
Q: What types of emotional and spiritual support does Unity provide?
Through a holistic approach to care, Unity cares not only for the physical symptoms, but the emotional and spiritual needs of our patients as well. Unity's interdisciplinary care team includes social workers, grief counselors and chaplains in addition to skilled nursing staff. Support programs are offered to the family both while serving as caregivers and after death. The Unity chaplains are able to help address spiritual concerns and needs, and can work in conjunction with a patient's faith leader, if desired.
Q: Does Unity provide any help to the family after the patient has died?
Yes. Unity team members offer caregivers bereavement care for minimally thirteen months following the death of a loved one. A bereavement plan of care is arranged with the team and the family and may include mailings, newsletters, invitations to support groups and individual grief counseling. Bereavement services are offered to all members of the community, regardless of their affiliation with Unity.
Q: Is it possible for a family member to receive bereavement counseling through Unity even if the patient did not receive Unity's services?
Yes. Unity's bereavement programs are available for any member of the community who has experienced the death of a loved one, whether or not the loved one used Unity's hospice care or treatment plus services. The bereavement programs are designed to support grieving people by helping adults, teens and children understand that grief is a natural and normal response to loss.
Q: How is payment handled?
Unity bills Medicare, Medicaid and insurance when it is available for hospice care and treatment plus and will accept patients regardless of their reimbursement source and ability to pay. Many of our patients are not encumbered with a bill due to our community care policy, recognizing people in need. Unity's staff is happy to coordinate and explain the payment process.
Q: If the patient is not covered by Medicare or any other health insurance, will Unity still provide care?
Unity accepts all patients regardless of their insurance status or income. Unity is fortunate to receive financial support from community donations for patients with limited or no insurance coverage, which helps us maintain our mission of ensuring that all individuals have access to support and quality holistic care.