What follows is a list of over 20 important questions to ask any hospice care provider before they enter your home.
A special thanks to American Life League for providing the location of this list. They mention it in a footnote in one of their recent articles, titled “Hospice and Palliativ Care: Ethical Concerns,” by Germaine Wensley, RN, in their Celebrate Life magazine. The list itself is found in a magazine available online, called Informed: A guide for critical medical decisions, published by Pro-life Healthcare Alliance.
Pro-life Healthcare Alliance includes this primer to their list of questions, found on page 13, for any hospice care provider:
“A hospice which respects the sanctity of life and truly abides by the founding principles of hospice—maintain dignity, increase quality of life, and provide comfort and pain control—can be trusted as a safe haven for patients in need of expert end-of-life care. In order to ensure full understanding, patients and families must do their homework by asking questions and getting a copy of the answers in writing (as any marketing or sales expert will tell a family what they want to hear).
“Hospice programs are independent from one another and the services provided are not the same. It is essential you interview a hospice prior to signing on for care and allowing them into your home. When seeking hospice care, keep in mind your values should come first and must never be compromised” (italics emphasis original, bold emphasis added).
Here are the questions Pro-life Healthcare Alliance recommends asking any hospice care provider, before permitting them to come to your home.
“1. What is the “mission” or “business statement” of the hospice?
2. Is the hospice non-profit or for profit? (#1)
3. Is the hospice pro-life? If yes, is this evidenced on the website, in brochures, mission, etc.
4. Is the hospice licensed by the state?
5. Is the hospice Medicare certified?
6. Has the hospice ever committed insurance fraud? Google the name of the hospice and Medicare fraud.
7. How many counties does the hospice serve? (#2)
8. Can I meet or speak by phone with the hospice administrator prior to hospice admission?
9. Can I meet the staff who will be providing care prior to admission?
10. What types of services are provided? How often will each of these services be provided to me (or my loved one)? Get these important details in writing.
11. Will services be provided by the same individuals throughout the course of my care?
12. What kinds of support are available to my family/caregivers?
13. How are services provided after hours? How long may it take for an on-call nurse to respond to my call? How long may it take for an on-call nurse to get to my home?
14. What do hospice volunteers do? Am I eligible for volunteer services?
15. Can the hospice provide care in a nursing home or personal care home/assisted living?
16. Must someone be with me at all times?
17. Must I commit to a DNR (Do Not Resuscitate) status?
18. Can I receive IV fluids and tube feedings?
19. What is the hospice’s position regarding Terminal Sedation (also called Palliative Sedation)?
20. Will I receive a bill for expenses not covered by insurance?
21. What should I do first if I am having a problem with the care my hospice is providing?
22. What should I do if I feel the hospice hasn’t addressed my concerns adequately?”
The magazine then adds these two footnotes:
“1. Most hospices caught for Insurance fraud are for-profits. Additionally, many for-profits are governed by shareholders concerned about returns on their investments. As a result, monies are often allocated away from the bedside and into their pockets. However, many non-profits also follow a business model resulting in the same problems. Therefore, asking about a hospice agency’s business status is as important as asking about profit status. If the hospice employs marketers, this is often an indication that they are more interested in keeping money in the bank than in providing services to patients. Any hospice that keeps saying “We don’t provide that” is not enhancing life and is most likely cutting costs at the bedside in order to enrich investors and pay executives’ salaries.
2. Hospice agencies often serve many counties from a single office. The on-call nurse may have difficulty reaching you quickly in an emergency as he/she may be several hours away.”
What do you think of Pro-life Healthcare Alliance’s list?
Do you know of another resource to recommend to people to interview any hospice care provider?
Please add any comments below.