Many people think hospice benefits solely cover in-home support for caregivers and patients with a terminal illness. But in reality, hospice can take place wherever a patient calls home — a private residence, nursing home, residential facility, or contracted inpatient facility or hospital. Hospice improves the quality of life in the final months or weeks, with enhanced palliative (comfort) care for patients and support for families.

While a majority of people express a desire to die at home, it’s not possible for some who need extra levels of care, safety, and supervision. Read more about how hospice works outside of the home and the benefits of utilizing the services hospice provides during the end of your loved one’s life. You’ll likely discover valuable support, dignity, and encouragement you didn’t know you needed.

“Endings matter, not just for the person but, perhaps even more, for the ones left behind.”

―Atul Gawande, author of Being Mortal: Medicine and What Matters in the End

Nursing Home or Residential Facility Hospice

When curative and life-prolonging treatments are no longer working or desired by a patient with a terminal diagnosis, Medicare hospice benefits make it easier on doctors and nursing home staff to provide pain management, comfort care, and supplemental services. Many nursing homes contract with local hospice companies, which they can recommend, but it is the right of the patient and caregivers to choose their hospice provider.

The nursing home staff maintains responsibility for much of the patient’s overall care: coordinating with hospice, routine daily care, monitoring the patient’s condition, attending doctor visits, and providing medications and supplies unrelated to the terminal illness.

Beyond the nursing facility, hospice provides a team of specially trained staff to support the patient, family members, and residential staff. A patient-centered, individualized plan for physical comfort, emotional and spiritual support, and grief and bereavement care is available. Hospice patients outside of the home can still expect:

  • Hospice nurse visits, typically once or twice a week, depending on condition; more frequently during the final days of life. 
  • A hospice nurse present at time of death when possible.
  • Hospice available 24/7 via on-call support.
  • Management of health issues for the final months of life, such as difficulty breathing, swallowing, and pain management.
  • Medications and supplies related to end-of-life care.
  • Education of family members and nursing home staff regarding the patient’s condition, medications, and symptoms to monitor.
  • Coordination of care with all medical providers, nurses, doctors, aides, and nursing home staff.
  • Emotional and spiritual support, counseling, and access to social services, spiritual care coordinators, and volunteers to provide presence, guidance, and compassion.

While the cost of housing or daily room and board are not typically covered by the Medicare hospice benefit, you may find traditional Medicare or other benefits provide coverage.

Inpatient Hospice at a Hospital or Center

Inpatient hospice care occurs when a patient needs short-term management of pain or symptoms that cannot be controlled at home or when respite care is needed. The patient is typically transferred to a hospital, skilled nursing facility, or inpatient hospice center. 

Families can rely on hospice experts to help coordinate care if their loved one is hospitalized. Many hospitals contract with hospice providers and can refer you. Similar to hospice patients in nursing facilities, a hospice team in the hospital will:

  • Help with aggressive symptom management and coordinate care.
  • Oversee that diagnostic tests and invasive procedures are discontinued to focus on comfort. 
  • Provide presence of a hospice nurse at the time of death when possible.
  • Offer family education regarding symptoms and management.
  • Lend emotional and spiritual support, counsel, and bereavement care for 13 months after the patient’s death.

The Medicare benefit covers inpatient hospice stays when eligibility for general inpatient or respite care criteria is met and can occur more than once. While the goal of hospice care is to manage pain and symptoms at home, reduce unnecessary hospital stays, and honor the patient’s desire to be at home, sometimes an inpatient stay is necessary. Patients can return home once symptoms improve.

Heart to Heart Hospice has homelike inpatient centers located in Texas (Houston and Fort Worth), Indiana (Evansville), and Michigan (Detroit area). If your loved one needs a hospice provider, see if Heart to Heart Hospice is available near you. Wherever your loved one needs support, hospice is ready to offer dignity, respect, and compassionate expertise.