Hospice: Compassionate Care at the End of Life When you or someone you love is facing a limited life expectancy, it can be a deeply challenging time for everyone. The end of a life can be an emotional and spiritual journey for the whole family—not an easy experience while taking care of many practical needs at the same time. Approaching the end of life can be difficult, but it's also a normal, natural process that can be peaceful, profound, and even joyful with the right support. Definition: What is hospice care? Hospice is a compassionate philosophy of care and an interdisciplinary set of services designed to support patients and families through the end-of-life process. Addressing the mental, physical, spiritual, and emotional needs of a patient and their family at the end of life, hospice focuses on pain relief and symptom management to provide dignity and quality of life at the end of life. Hospice services may include: Where is hospice care provided? Hospice is not a place; it is a service that can be provided wherever you call home. For some, that may be a private residence or family home. For others, it may be a nursing home or assisted living facility. How can hospice care help? Hospice professionals are specially educated and trained to provide comprehensive, interdisciplinary end-of-life services customized to meet the client's and family's needs and wishes. Overseen by a medical director, an individual's hospice care team works collaboratively with the patient to identify their personal goals, create an individualized plan of care, and coordinate and provide practical, emotional, medical, social, and spiritual support for the patient, family, caregivers, and other loved ones. Hospice services focus on people and their meaningful time together, enabling patients to live the rest of their lives with dignity and comfort wherever they call home. As part of the care plan, hospice can bring sources of joy into the home, facilitate wish fulfillment, give family caregivers needed breaks (known as respite care), and facilitate important conversations about end-of-life planning decisions such as choosing a power of attorney, writing a will, or expressing the patient's health care wishes in an advance directive. Who pays for hospice care? Medicare, Medicaid, and most private insurance providers offer benefits that cover the cost of hospice care. In fact, with insurance coverage, sliding scales, or charitable support: 99% of patients pay nothing out-of-pocket for the cost of hospice care. Ask your insurance provider or hospice care provider what benefits may be available for you. Eligibility for the Medicare Hospice Benefit A patient is eligible for hospice care through the Medicare Hospice Benefit if: They are eligible for Medicare Part A Their doctor and the hospice medical director certify that they have a life-limiting illness and death may be expected in six months or less They receive care from a Medicare-approved hospice program What are the different levels of hospice care? There are four distinct levels of care: Routine Home Care: The basic level of care under the hospice benefit, wherever a patient calls home Continuous Care: During a crisis, hourly care can be provided at home for 8 to 24 hours a day until the crisis is resolved. Inpatient Care: For patients who have short-term symptoms so severe they cannot get adequate treatment at home, or they may feel more comfortable getting inpatient treatment Respite Care: Skilled, short-term relief for primary caregivers; temporarily taking over caregiving responsibilities to prevent caregiver burnout (can be provided on a planned or emergency basis) When should hospice care begin? The decision to begin hospice care is made by the patient in collaboration with their doctor and family. Many former patients, reflecting on the help and peace of mind their hospice care team gave them, said they wish they had begun hospice services sooner than they did. In general, a patient should consider hospice as soon as they decide to stop trying to cure their illness or prolong their life. If they qualify, hospice services can help optimize their comfort and quality of life, fulfill their wishes, provide practical and emotional support for the household, and guide any conversations loved ones need to have to resolve personal issues, make their end-of-life care plans, and get their affairs in order. Typically, insurance providers will approve hospice care when a medical doctor has given the patient a life-expectancy prognosis of 6 months or less. If a patient's condition stabilizes, they can go off hospice for a period, then go back onto hospice services if and when needed. What are hospice eligibility requirements? In order to begin hospice care, patients must meet the hospice eligibility requirements established by the U.S Centers for Medicare & Medicaid Services. There is no specific number of symptoms that is required when qualifying for hospice. These criteria help determine if a patient's condition is or will soon be appropriate for hospice care. Hospice eligibility requirements To be eligible for hospice, you must have a prognosis of 6 months or less from your doctor and hospice medical director. Hospice indicators If you are experiencing any of the symptoms listed, you should talk to your doctor. Frequent hospitalizations within the last 6 months Progressive weight loss Increasing weakness, fatigue, or sleepiness Recurrent infections Skin breakdown Changes in cognitive or functional abilities Problems with activities of daily living (ADLs) such as eating, bathing, toileting, dressing, or walking Specific decline in condition What is palliative care? Hospice care and palliative care overlap and often are confused. An easy way to remember the difference is that all hospice care is palliative (plus much more), but not all palliative care is hospice. Hospice care is provided near the end of life, while palliative care can be provided at any stage of an illness. Palliative care is a health care specialty with the goal to relieve pain and suffering, and that goal can be achieved with a combination of interventions that may be medical (symptom management, pain medication) and non-medical (diet and nutrition, positioning, relaxation therapies, creating a calm, soothing environment). Common diagnoses that can benefit from palliative care: ALS Stroke Alzheimer's disease Dementia MS Chronic liver disease HIV/AIDS Renal disease Kidney failure Respiratory (lung) disease COPD Heart disease Congestive heart failure(CHF) Cancer Common symptoms that can benefit from palliative care: Emotional distress Spiritual distress Anxiety Depression Sleep disorder Delirium Fatigue Loss of appetite Constipation Diarrhea Nausea Vomiting Shortness of breath Hospice vs. Palliative Care: What's the difference? What do palliative care and hospice have in common? Both are types of comfort care that aim to reduce stress and offer complex symptom relief related to a serious illness, and both address physical and psychosocial relief. What are the key differences? Palliative care is for those seeking curative treatment in addition to symptom management. Hospice care is specifically for those with a prognosis of six months or less who are not seeking curative treatment. Hospice care is delivered wherever the patient calls home. Palliative care teams typically work in a hospital, although palliative care can also be delivered at home. Hospice care costs are paid by Medicare, Medicaid, and private insurance. Hospice is the only Medicare benefit that includes pharmaceuticals, medical equipment, 24/7 access to care, nursing, social services, chaplain visits, grief support, and other services deemed appropriate by the hospice agency. In comparison, palliative care costs from office visits to prescription charges are typically paid for by private insurance or the patient. End-of-Life Care Planning Choosing a hospice care provider When choosing the right hospice provider for you or a loved one, there are a number of important factors to consider. Click here for a checklist of useful questions to ask. The Importance of Talking about End-of-Life Care Communicating Your Wishes at the End of Life Your end-of-life wishes are more likely to be acknowledged, honored, and followed if you are benefiting from hospice care. Although sometimes a difficult conversation, it's important to talk to their loved ones about their wishes, rather than waiting for the subject to come up. One way to communicate your wishes is through an Advance Directive. Take Control An Advance Directive is a legal document that helps you plan and communicate your end-of-life wishes. When you create an advance directive, you are being proactive about your medical care and sparing your loved ones from having to make difficult medical decisions in a time of crisis. Before encountering a crisis, create your Advance Directive, share copies with your loved ones and your doctor, and keep a copy in an accessible location that others can find. Advance Care Planning Advance care planning is making decisions about the care you would want to receive if you become unable to speak for yourself. Advance care planning includes: Getting information on the types of life-sustaining treatments that are available Deciding what kind of treatment you would or would not want should you be diagnosed with a life-limiting illness or become incapacitated Sharing your personal values with your loved ones BAYADA Hospice Care Services BAYADA is a mission-driven, not for profit organization focused on providing exceptional care. We understand that this can be a difficult, emotional time for both patients and caregivers, and important concerns may arise for you at any hour of the day or night. You don't have to go through this journey alone. At BAYADA Hospice, it is our greatest honor to help others feel cared for and supported in their time of need. If you have questions about hospice care or just want to talk, call us anytime, 24/7, at (888)-470-7545 Our compassionate specialists can answer your questions and help you understand your options. BAYADA Hospice Services: Our interdisciplinary team creates an individualized care plan in collaboration with the patient, doctor, and family to meet our patients' unique needs. Our comprehensive services include: Nursing care: A patient is assigned a registered nurse case manager. Patients and their families can also access an on-call nurse 24 hours a day. Physicians oversight: All BAYADA Hospice services are overseen by a physician medical director. Medical social work: Social workers can assist patients and families with their emotional and/or social needs and refer them to needed services. Aide services: Aides can help patients with their personal care needs. Therapies: Physical, occupational, and/or speech-language therapies are integrated into the care plan when appropriate. Grief and bereavement support: Loved ones have access to a full range of bereavement services for up to 13 months after a patient passes away. Spiritual care: Clergy members or spiritual counselors can provide support for patients and their families. Medical equipment: Hospice provides the equipment necessary to provide a safe, comfortable, caring environment in the patient's home that might include a hospital bed, wheelchair, oxygen, and more. Respite care: This form of temporary, short-term assistance can help alleviate or avoid caregiver burnout and stress. Volunteer services: Hospice volunteers can perform a wide variety of tasks, including companionship, running errands, playing music, or helping in the hospice office. We can be there within 24 hours There's nothing more precious than time with loved ones. BAYADA will be there when you need us to begin hospice services, usually within 24 hours of your call. Or, with no obligation to use our services, we can just visit you at home to assess your needs and answer questions. We custom-match you with the best caregivers Relationships. That's what makes our one-on-one care so special for patients and so rewarding for caregivers. We learn about you and hand-select a hospice care team who not only have the skills and experience to meet your needs, but are a great fit personally and that makes all the difference. We provide family education Sharing knowledge is a key part of how BAYADA Hospice brings reassurance and peace of mind to patients and their loved ones. Gentle, age-appropriate information can make an important difference in how people experience death or loss. Our professionals are equipped to explain the end of life and to educate clients and family members of all ages children and adults about what to expect during the dying process and in one's final days. With compassion, we help bring clarity to the unknown. We can bring comfort and meaning to the end of life Whenever possible, joy fulfillment is an important part of the BAYADA Hospice approach starting with a life review, where a qualified professional helps the patient identify their own goals and priorities, what relationships may need attention, what makes them happy, and any final wishes. It is our greatest honor to help others feel cared for and supported through the end-of-life journey as we did for these patients and their loved ones: Former Pilot takes flight [Read Story] Anniversary Celebration [Read Story] Quality time with grandkids [Read Story] Daughter's wedding [Read Story] Honors for WWII vet [Read Story] We honor the unique needs of veterans As a proud partner of We Honor Veterans (a program of the National Hospice and Palliative Care Organization), BAYADA Hospice educates and trains our care professionals to provide the highest quality, specialized hospice care and counseling for veterans, who often have unique needs related to their service experiences. About BAYADA Home Health Care BAYADA Hospice is a specialty practice of BAYADA Home Health Care, founded by J. Mark Baiada in 1975 with a special purpose to help people have a safe home life with comfort, independence, and dignity. BAYADA provides a continuum of care for our patients and families that includes: nursing, rehabilitative, therapeutic, hospice, and assistive care services to children, adults, and seniors worldwide, 24 hours a day, 7 days a week.* In 2019, Baiada oversaw the company's unprecedented transition to a not for profit organization to ensure BAYADA's mission, purpose, and business model would endure, and to help BAYADA realize its vision of helping millions of people worldwide experience a better quality of life at home. For more information, visit bayada.com. Our Hospice Service Locations We provide hospice services in DE, NC, NH, NJ, PA, and VT: DELAWARE Wilmington, DE Phone: 302-351-3633 NEW HAMPSHIRE Concord, NH Phone: 603-724-6689 NORTH CAROLINA Fayetteville, NC Phone: 910-223-5369 NEW JERSEY Jersey City, NJ Phone: 201-630-2158 Toms River, NJ Phone: 609-387-6410 Haddon Heights, NJ Phone: 856-845-8220 Mt. Laurel, NJ Phone: 856-722-7058 Northfield, NJ Phone: 609-813-2149 PENNSYLVANIA Boyertown, PA Phone: 610-367-1608 Wilkes-Barre, PA Phone: 570-994-1514 Media, PA Phone: 610-627-2050 Warminster, PA Phone: 215-343-3314 VERMONT Brattleboro, VT Phone: 802-490-2099 Colchester, VT Phone: 802-448-1610 Norwich, VT Phone: 802-526-2380 Rutland, VT Phone: 802-282-4122 To learn more about BAYADA’s core values, click here. Contact Us First Name* Last Name* Email* Postal Code* Phone Number* I'm interested in* - Please Select - Services Careers Let's connect. You can call us, or we'll call you. 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