hospicegeneralbrochure

What is Hospice?

United Hospice of Rockland, Inc. provides specialized care for people facing a serious illness.  Together we develop a personalized plan of care to help you live each day to the fullest.  We will provide you and your family members with the support and guidance that you need.  Our services include:

• Nurses, including on-call nurses who are available 24 hours/day.

• Home health aides

• Social workers

• Physician care

• Spiritual support

• Nutritionist

• Therapies (Physical, respiratory, occupational, speech, music and massage)

• Volunteers

• Medications

• Medical equipment and supplies

When is the Right Time to Call?

The sooner we become involved, the sooner we can help.  Others who have benefited from our services often tell us, “I wish I had come to Hospice sooner”.  We will contact your doctor and meet with you to help determine the right time for services to begin.  Call us now – we are ready to help.

Why Should I Choose Hospice?

Hospice offers the best possible care for people facing serious illness.  We will offer you choices about your care and help you to maintain control over decisions that affect you.  Our expert staff will make every effort possible to keep you comfortable in surroundings that can best meet your needs.  We will provide the emotional and practical support you and your family need during this time.  We will help to preserve your dignity.

Who can Receive Services?

If you live in Rockland County or lower Orange County, have a serious illness and are in agreement with the goal of comfort care, we are here to help you.  We serve people of all ages from infants to seniors.  Hospice provides an enhanced quality of life for people with illnesses that include:

• AIDS

• Cancer

• Diseases of the heart, lungs, kidneys and liver

• Neurological disease including Parkinson’s disease, ALS, and Alzheimer’s/Dementia 

Where can I Receive Services?

Our specialized and highly skilled comfort care is provided primarily in patients’ homes.  We are also able to provide assistance in most local hospitals, skilled nursing facilities, assisted living facilities, group homes and other residential settings.  If we are contacted on a timely basis, we can ease the transition from one setting to another.

Who Pays for Services?

Most insurance carriers (including Medicare and Medicaid) cover hospice care.  Our staff can work with your insurer to arrange coverage.  If you do not have health insurance, you may qualify for reduced fees or other special considerations.  Most important, no one is ever turned away because they cannot pay for care.

Myths and Facts about Hospice

Myth: Hospice only provides care for people diagnosed with cancer.
Fact: Hospice provides care for seriously ill individuals and their loved ones regardless of diagnosis.

Myth: Hospice care is for individuals who are very close to death.
Fact: An early referral to our program enables individuals and families to fully benefit from our services and support.  If you think you or a loved one might benefit from hospice services, feel free to call us.

Myth: Hospice patients must be home bound.
Fact: Patients need not be home bound to receive services.  We help patients to be as active as possible.

Myth: Choosing hospice means the patient no longer receives treatments or therapies.
Fact:  Treatments or therapies may be administered to provide comfort care.  When appropriate, patients can receive chemotherapy, radiation, transfusions, physical therapy, and massage therapy.

Myth: Hospice provides care only for patients.
Fact: Hospice also focuses attention on the patient's family.  Emotional and spiritual support as well as caregiver education and volunteer services are geared to meet the needs of loved ones.

Myth: Only senior citizens can receive hospice services.
Fact:  Hospice care is available for people of all ages - infants, children, adults and seniors.

Myth: Hospice patients can no longer see their own physician.
Fact:  Hospice encourages patients’ physicians to follow the patient and participate in their care.

Myth: Accepting hospice care means that hope is lost.
Fact:  Hope for cure is transformed to hope for comfort, acceptance and peace. 

Myth: Hospice care is only for those with private insurance.
Fact:  Hospice serves everyone, regardless of ability to pay.  Hospice is fully covered under Medicare, Medicaid and most private insurance plans.

Myth: Hospice patients must have a DNR (Do Not Resuscitate) order in place in order to receive services.
Fact:  There is NO requirement for a patient to have a DNR order.

Myth: Once someone is admitted onto the hospice program, they cannot leave.
Fact:  Individuals can choose to discontinue hospice services at any time.

Myth: Hospice staff encourages the use of morphine for all hospice patients.
Fact:  Each person’s symptoms are controlled in a way that works best for them.

Guidelines for Referring to and Selecting a Hospice

When there are multiple hospices in a community, it makes it more challenging to make the right choice. Although the general philosophy of hospice care is similar across hospices, all hospices are not created equal. Criteria you may want to evaluate as you interview or select the hospice to provide care for your loved one (or for someone you are referring for hospice care) should include: a reputation of distinction, standards of excellence in caring for the client, the care that can be provided by all disciplines for routine and urgent needs, a bereavement program that provides options for families and caregivers, and a mission of compassion.

• Is the hospice Medicare certified and state licensed? (the latter, if applicable)
• Is the agency accredited by a nationally recognized accrediting body, such as the Joint Commission on Accreditation of Healthcare Organizations?
• Are they an accredited charity by the New York Better Business Bureau?
• How many years has the hospice been serving your community?
• Can the hospice provide references from professionals, such as a hospital or community social workers, who have used this agency? Ask for specific names and telephone numbers.
• How flexible is the hospice in applying its policies to each patient?  Does the hospice accept patients on respirators? On chemotherapy? Receiving radiation therapy? Provide blood transfusions?, etc.
• Does the hospice create a plan of care for each new patient? Is the plan carefully and professionally developed with the patient, family and staff (and the facility in which the patient resides)?
• Does the hospice provide home health aide services?  Are the aides employed by the hospice or are they from a contract agency?   (When a hospice employs aides, it demonstrates their personal investment in the provision of this service.) How is the amount of aide time determined?   If the amount of aide time is not adequate to meet a family’s needs, what steps does the hospice take?
• Can you call the hospice twenty-four hours/day to make a referral and speak with a staff member?  If the call is answered by an answering service, do they page a staff member for you? Try calling the hospice, during off hours, to test their response time.  Do they convey an attitude of caring, patience and competence?  Do they sound attentive to your needs and concerns?
• How quickly after making a referral can the patient be evaluated by the hospice nurse?
• Will the nurse visit at any time of the day or night?   Have the hospice describe under what circumstances a nurse will visit during the night or on a weekend.   How far away is the nurse on-call located?  Will the nurse visit if a facility makes the request for assistance or reports a change in status?  
• With what facilities does the hospice contract to provide inpatient care?
• Under what circumstances does the hospice provide continuous care?  (This is shifts of nursing and aide service for a minimum of eight hours.)  Are the continuous care staff employees of the hospice, through an agency contract or both?
• What quality of life enhancing services that are NOT mandated by the government are provided by the hospice?  Example: music therapy, massage therapy, pet therapy, etc.
• What services do volunteers provide?   How many volunteers does the hospice have?  Have the volunteers received special training related to patients residing in nursing homes and/or other facilities?
• Is the hospice medical director board certified in hospice and palliative care?  What is the role of the medical director?
• How many nurses are certified in hospice and palliative care?
• What bereavement services are available?   Individual counseling?  Bereavement groups? Are there special services for children?  What bereavement services are available to the staff at nursing homes, group homes and assisted living facilities?
• How does the hospice ensure that quality care is provided?
• Who can you call with questions or complaints? What is the procedure for resolving issues?
• Is the hospice a for profit or not-for-profit entity?

We hope that you find this guide useful.  If you have any questions, feel free to call us at 845-634-4974.

Nursing Home Program

United Hospice of Rockland enables nursing home residents who are seriously ill to remain in a familiar and supportive environment while receiving relief from pain and other symptoms.  In coordination with the nursing home team, UHR provides the guidance and special care needed to help residents and their families achieve comfort and peace of mind.

• Who is Eligible for our Nursing Home Program?

• Nursing Home Services

• Local Nursing Homes With Hospice Contracts

Who is Eligible for our Nursing Home Program?

Nursing Home Services

United Hospice of Rockland is a unique health care provider.  Rather than concentrating solely on the physical aspects of care, our focus is on the whole person. The hospice approach also provides for the psychological, social and spiritual dimensions of care and support.

Hospice services are provided by an interdisciplinary team of highly skilled health care professionals including: physicians, nurses, social workers, spiritual caregivers, bereavement counselors, volunteers and other specialists as needed.  All are trained to work with individuals with serious illness.  Emotional support and guidance are also provided to the residents' family members.  Residents entering UHR's hospice program remain under the care of the nursing home physician.  In addition, the UHR medical director is available for consultation.

Social workers help residents and their families make emotional adjustments.  They can be effective in assisting families improve communication, in teaching relaxation techniques to decrease anxiety and in locating community resources.

Spiritual caregivers offer comfort to residents and families.  They can serve as a bridge between residents and their church or synagogue.

Volunteers supply a variety of services to meet a resident's needs. They can become friendly visitors who listen with care and compassion.

Home health aides provide personal care to supplement that of the nursing home's staff.

Bereavement counselors extend individual and group support to families for up to one year after the death of their loved one.

Hospice nurses are on call 24 hours a day/7 days a week to address any patient needs or family concerns.

UHR Nurses work in collaboration with nursing home staff to:

• Direct and coordinate the plan of care for residents.

• Answer questions and offer emotional support to residents and their families.

• Assess residents and consult with physicians to insure effective symptom and pain control.

• Provide information and recommendations.

Local Nursing Homes With Hospice Contracts

UHR currently provides hospice services in the following area nursing homes:

Frequently Asked Questions about Hospice

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

At any time during a serious illness, it is 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 the disease.  Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family.

2. Should I wait for our physician to raise the possibility of hospice, or should I raise it first?

The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.

3. 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 the Academy of Hospice Physicians, medical societies, state hospice organizations, or United Hospice of Rockland at (845) 634-4974.

4. Can a hospice patient who shows signs of recovery be returned to regular 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, Medicare and most private insurance will allow additional coverage for this purpose.

5. What does the hospice admission process involve?

One of the first things Hospice will do is contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. United Hospice of Rockland has a medical director available to help patients who have no physician.

The patient will also be asked to sign a consent form.  It is similar to the form patients sign when they enter a hospital.

The consent form says that the patient understands that the care is palliative (aimed at pain relief and symptom control) rather than curative.  It also outlines the services available.  The form also explains how electing the Medicare hospice benefit affects other Medicare coverage for a serious illness.

6. Is there any special equipment or changes I have to make in my home before hospice care begins?

Hospice will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment.  Often the need for equipment is minimal at first and increases as the illness progresses.  In general, Hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

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

There is no set number. One of the first things the hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed in your situation. Hospice staff visits regularly and are always accessible to answer medical questions and provide support.

8. What specific assistance does hospice provide home-based patients?

Hospice patients are cared for by a team of doctors, nurses, social workers, counselors, home health aides, clergy, therapists and volunteers -- each provides assistance based on his or her area of expertise.  In addition, Hospice provides medications, supplies, equipment, and hospital services if and when needed.

9. Does hospice do anything to make death come sooner?

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 advanced illness.

10. Is caring for the patient at home the only place hospice care can be delivered?

No. Although 90% of hospice patient time is spent in a personal residence, some patients live in nursing homes, a family member's home, an assisted living facility or group home.  We will offer services wherever the patient is.

11. How does hospice manage pain?

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, as it addresses each.

Hospice nurses and doctors are up to date on the latest methods used to control pain and achieve symptom relief. Using some combination of medications, counseling and therapies, most patients can be kept pain free and comfortable.

12. Will medications 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 pain free but alert. By constantly consulting with the patient, Hospice has been very successful in reaching this goal.

13. Is hospice affiliated with any religious organizations?

Hospice is not an off-shoot of any religion. While some churches and religions have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs. UHR offers spiritual care to people of all faiths.

14. Is hospice care covered by insurance?

Hospice coverage is widely available. It is covered by Medicare, by Medicaid in New York State, and most private health insurance policies.  To be sure of coverage, hospice will check with your health insurance provider.

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

The first thing Hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of.  Barring this, care is provided regardless of one's ability to pay.  Hospice staff will do a financial assessment to determine any fees that the patient may be required to pay.

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

Hospice provides continuing contact and support for family and friends for 13 months following the death of a loved one.  United Hospice of Rockland also provides bereavement groups and support for anyone in the community who has experienced the death of a loved one.

17. How is hospice care different from other types of home health care?

• Comfort vs. cure: For most health care providers, the goal is to get the patient well.  Hospice focuses on comfort and support, rather than cure.
   

• Interdisciplinary team approach: All members of the care team - nurses, social workers, bereavement counselors, spiritual care coordinators, home health aides and volunteers - work together to coordinate care.
   

• Family focus: Hospice care focuses on the entire family. The Hospice team teaches the family how to be involved in their loved one's care.
   

• Bereavement Support: Hospice care does not end when a patient dies. UHR’s Provident Bank Hope and Healing Center offers bereavement support for family members for at least 13 months after the death of a patient.