Busting Senior-Care Myths: You Can’t Be at Home for Hospice Care

Here’s a senior-care myth that’s ripe for debunking: A surprising number of people assume hospice care only takes place in special hospice facilities. That belief can discourage families from looking into hospice services when their loved one is terminally ill. However, advocates of hospice care say it’s more accurate to think of hospice as a type of care rather than as a place. According to the American Hospice Foundation, most hospice care takes place in patients’ homes, and people can get hospice care in a variety of settings, including assisted living, nursing homes, hospitals, and—yes–residential hospice centers. Read on to learn more about where your parents can receive hospice care when they need it.

Hospice care in the patient’s home

What can you expect if your parents get hospice care at home? According to Medicare guidelines, there will be a hospice care team that includes an on-call doctor and nurse along with other healthcare professionals your parents may need. For example, your parents’ hospice doctor may recommend visits from a speech-language pathologist if your parent has trouble swallowing, or a social worker to help your family apply for benefits and find counseling. Your parents can still keep their regular physician, who can coordinate care with the hospice doctor.

Other hospice team members include home health aides, homemaking helpers, and volunteers who may offer to run errands, tackle small chores, or just sit with your parents while you get something to eat or take a break. The goal of hospice care is not only to keep your parent comfortable and well-cared for but also to support your family.

Hospice care at a family member or friend’s home

Although hospice in their own home is the option many people prefer, it’s not always workable. There are many reasons why it might not be practical for your parents to get hospice care in their own home. For example, if your parents live in a very rural area, finding hospice workers who can make the long drive to their home may be difficult or impossible. Older homes can sometimes be problematic, too – a lack of central air conditioning, reliance on a wood stove for heat in winter, and other home-system issues may mean it’s safer and more comfortable for your parents to get hospice care in the home of a family member or a friend.

If your parents can’t receive hospice care in their own home, the next best option is the home of whoever is willing to serve as a primary caregiver and handle the logistics of hospice care visits. If one adult child is taking on this responsibility, it’s a good idea to have a family discussion with siblings and other relatives about their care responsibilities during the hospice period.

Hospice care in assisted living

If your parents are already in an assisted living community, they may be able to get hospice care from Medicare-certified providers without having to move. That option will depend on whether their particular assisted living community allows outside service providers to come in and help residents. It also depends on the law in your parents’ state. In a few states, assisted living facilities are banned from providing or hosting hospice care. If your parents live in South Carolina, they may need a waiver to get hospice services in their assisted living community.

Should your family go this route, be proactive about solving communication gaps between the hospice care providers, the assisted living staff, and your family. It may be worth scheduling an in-person meeting with all your parents’ caregivers to set up a clear chain of communication so there are no lapses or oversights in your parents’ care. Put a plan in writing so everyone who cares for your parents knows what to expect.

Hospice care in a nursing home

If your parents live in a nursing home, they can still receive visits from hospice care workers, and many hospice advocates strongly recommend that families use the Medicare hospice resources available to them. As the Hospice Action Network puts it, “End of life care is very different from general medical services and quite specialized. While hospice tends to the end of life needs of the patient, regulations require the nursing home to provide custodial services just as a family would in a home setting. So, while the roles of the hospice and the nursing home are complementary, they are very distinct.”

As with hospice care in assisted living, it’s a good idea to begin by meeting with your parents’ hospice care and nursing home care coordinators to come up with a clear plan of who is responsible for which tasks and how information will be shared. In general, routine care is handled by the nursing home staff and care for your parents’ life-limiting condition is the responsibility of the hospice care providers, but there may be some overlapping or similar tasks that need clarification.

Hospice care in the hospital

If your parents need to be hospitalized due to an acute illness or injury while they’re in hospice care, they should still be able to receive their hospice services in the hospital. The American Hospice Foundation says that some hospitals designate beds or units for hospice patients to ensure that they get the pain management and extra care that they need. One thing to keep in mind is that your parents’ hospice care team should be the ones who decide if your parents need to go to the hospital. That ensures that your parents’ care is coordinated clearly between the hospice doctor and nurses and the hospital staff. It’s also required by Medicare in order for the program to pay for the hospitalization.

Hospice care in a residential hospice center

Residential hospice centers are what many people think of when they hear the word “hospice.” These homey, live-in facilities can be the best option for people who need hospice services, can’t live at home, and don’t already live in an assisted living community or nursing home. When you’re considering residential hospice options, make sure they are Medicare-certified. Check online reviews, talk to other families who’ve used the center’s services, tour the facility, and talk to the staff before you make a decision to place your parent there.

For detailed information about hospice care options near you, contact SeniorAdvisor.com’s local experts at 1-800-805-3621.

Casey Kelly-Barton

Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.