Hospice At Home

Spending the last days at home:

When people face the end of life, they prefer if possible, to spend their last days at home – alert and pain fee – among the people and things they love.  Visiting Nurse Service & Hospice of Suffolk is dedicated to making this possible.  Hospice care emphasizes effective pain control and symptom management in combination with supportive counseling services to the entire family.  All care is provided under the direction of the patient’s primary physician.

Who helps?

Typically, a family member or friend serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual.  Hospice supplements the daily care provided by the primary caregiver with a team that consists of a registered nurse, physician, social worker, clergy, home health aides and volunteer, all working together to plan and coordinate care.

Members of the team make regular home visits and a nurse is on-call 24 hours a day, 7 days a week to provide advice over the telephone and to make visits when necessary.

You have choices

Hospice care can be provided in a number of settings. 

  • Routine care is most often given in the home, but inpatient care can also be provided in either a nursing home, hospital or the Hospice House.  The Hospice House, located in East Northport, NY, is VNSHS’ eight bed inpatient unit designed specifically to meet the needs of terminally ill patients and their families as they face the end of life. 
  • Inpatient respite care.  For patients who do not meet the criteria for inpatient care, Respite care is employed on a limited basis when it is believed that the patient’s caregiver(s) would benefit from some rest from the daily care they provide at home.
  • Stopping Care If the patient chooses to stop hospice care, health care benefits from the standard or managed care Medicare program continue.  If the terminally ill patient’s health improves, or if the patient goes into remission, their regular health care benefits will resume as well.  A patient can return to hospice care at any time as long as the eligibility criteria are met and certification by the physician and hospice team is received.

Myths About Hospice

Myth #1: Hospice is a place

Hospice care takes place wherever the need exists — usually the patient’s home. About 80 percent of hospice care takes place at home.

Myth # 2: Hospice is only for people with cancer

More than one-fifth of hospice patients nation-wide have diagnoses other than cancer. In urban areas, hospices serve a large number of HIV/AIDS patients. Increasingly, hospices are also serving families coping with the end-stages of chronic diseases, like emphysema, Alzheimer’s, cardiovascular, and neuromuscular diseases.

Myth #3: Hospice is only for old people

Although the majority of hospice patients are older, hospices serve patients of all ages. Many hospices offer clinical staff with expertise in pediatric hospice care.

Myth #4: Hospice is only for dying people

As a family-centered concept of care, hospice focuses as much on the grieving family as on the dying patient. Most hospices make their grief services available to the community at large, serving schools, churches and the workplace.

Myth #5: Hospice can only help when family members are available to provide care

Recognizing that terminally ill people may live alone, or with family members unable to provide care, many hospices coordinate community resources to make home care possible. Or they help to find an alternative location where the patient can safely receive care.

Myth #6: Hospice is for people who don’t need a high level of care

Hospice is serious medicine. Most hospices are Medicare-certified, requiring that they employ experienced medical and nursing personnel with skills in symptom control. Hospices offer state-of-the-art palliative care, using advanced technologies to prevent or alleviate distressing symptoms.

Myth #7: Hospice is only for people who can accept death

While those affected by terminal illness struggle to come to terms with death, hospices gently help them find their way at their own speed. Many hospices welcome inquiries from families who are unsure about their needs and preferences. Hospice staff are readily available to discuss all options and to facilitate family decisions.

Myth # 8: Hospice care is expensive

Most people who use hospice are over 65 and are entitled to the Medicare Hospice Benefit. This benefit covers virtually all hospice services and requires little, if any, out-of-pocket costs. This means that there are no financial burdens incurred by the family, in sharp contrast to the huge financial expenses at the end of life which are incurred when hospice is not used.

Myth # 9: Hospice is not covered by managed care

While managed care organizations (MCOs) are not required to include hospice coverage, Medicare beneficiaries can use their Medicare hospice benefit anytime, any where they choose. They are not locked into the end-of-life services offered or not offered by the MCOs. On the other hand, those under 65 are confined to the MCOs services, but are likely to gain access to hospice care upon inquiry.

Myth # 10: Hospice is for when there is no hope

When death is in sight, there are two options: submit without hope or live life as fully as ever until the end. The gift of hospice is its capacity to help families see how much can be shared at the end of life through personal and spiritual connections often left behind. It is no wonder that many family members can look back upon their hospice experience with gratitude, and with the knowledge that everything possible was done towards a peaceful death.

By Naomi Naierman,

President and CEO of the American Hospice Foundation. Reprinted with permission from the American Hospice Foundation. Copyright 1999 American Hospice Foundation. All Rights Reserved. Further distribution, reprinting, performance, display, or use of this article, as well as the creation of any derivatives or other modifications of it, is prohibited without the express, written authorization of American Hospice Foundation. Additional information is available at American Hospice Foundation’s website at www.americanhospice.org.