• Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.
• Hospice care neither prolongs life nor hastens death. Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management.
• The goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity.
• Hospice care is provided by a team-oriented group of specially trained professionals, volunteers and family members.
• Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.
• Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends.
• Hospice offers a variety of bereavement and counseling services to families before and after a patient's death.

     Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week.

     The hospice team develops a care plan that meets each patient's individual needs for pain management and symptom control. The team usually consists of:

• The patient's personal physician
• Hospice physician (or medical director)
• Nurses
• Home health aides
• Social workers
• Clergy or other counselors
• Trained volunteers
• Speech, physical, and occupational therapists, if needed.

     Among its major responsibilities, the interdisciplinary hospice team:

• Manages the patient's pain and symptoms
• Assists the patient with the emotional and psychosocial and spiritual aspects of dying
• Provides needed drugs, medical supplies, and equipment
• Coaches the family on how to care for the patient
• Delivers special services like speech and physical therapy when needed
• Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time
• Provides bereavement care and counseling to surviving family and friends

     Hospice is covered under Medicare, Medicaid and most private insurances. Serenity Hospice also has a sliding fee scale as well as an indigent program through the Serenity Hospice Foundation. Regardless of ability to pay, please contact us.

Hospice care is a covered benefit under Medicare for patients with a prognosis of 6 months or less. A patient can remain in hospice care beyond six months if a physician re-certifies that the patient is terminally ill.

     The benefit covers all services, medications and equipment related to the illness. These include:

• Physician services
• Nursing services
• Home health aides
• Medical appliances and supplies
• Spiritual, dietary, and other counseling
• Continuous care during crisis periods
• Trained volunteers
• Bereavement services

     Approximately 43 states and the District of Columbia offer hospice coverage under Medicaid.

     Many private health insurance policies and HMO's offer hospice coverage and benefits.

     Regular Medicare coverage is available to Hospice beneficiaries for non-terminal related services.

     The Health Care Financing Administration (HCFA) certifies hospices that provide Medicare covered hospice services.

     Anyone can make a referral for Serenity Hospice services--you, your physician, a family member, a friend or a neighbor. Once a referral is made, a Serenity Hospice representative will schedule a visit with the patient and/or their loved ones, to assess the best type of care for the patient and their loved ones. Usually, care can begin within a day or two of a referral. For more information or to make a referral, simply call Serenity Hospice at 1-800-616-1201.

     No. Although all hospices specialize in care for the terminally ill, the quality of care and extent of services can differ widely among hospice care providers. Many hospices operate as part of large, for-profit healthcare systems, while others operate as not-for-profit organizations. In most cases, patients have a right to choose which hospice program they wish to utilize. In most cases, you have a choice of which hospice program to use. Serenity Hospice offers comprehensive services to adults, children and infants with advanced illness throughout 12 counties in Western Central Indiana.

Any person, regardless of income, who faces an incurable illness with a prognosis of six months or less, as well as family members who are caring for a dying person, may receive Serenity Hospice Inc. services. A person may call Hospice directly, or be referred by a doctor, family member, volunteer hospice, local hospital, or another helping organization.

     If a patient lives in a nursing home, Serenity Hospice can ensure that the patient can receive hospice care while in the nursing home. Hospice is a nursing home combining the best of two systems of care and enhances the patient's life and needs.

For example, patients can receive increased attention from nurses; additional hours of attendant care; special attention to needs such as pain control, skin care and nutritional issues; the emotional, social and spiritual support to deal with challenging, end-of-life issues; and, social support through volunteers. Perhaps best of all, patients are made to feel at home in the nursing home and are reassured that they are still an important and active part of their families and communities.

     Hundreds of times each year, patients and families tell us: "We wish we'd entered the hospice program sooner." It is a common misconception that hospice care is only for the last few days of life hen, in face, patients and families can benefit most when they have hospice for the final weeks or months of life.

     Hospice is beneficial for anyone, of any age, with any life-limiting disease. Through many patients have caner, Serenity Hospice also has great expertise in providing comfort and symptom control for patients in the final stages of lung, heart and kidney disease, Alzheimer's and other types of dementias, stroke, neuromuscular diseases, AIDS and many other illnesses.

     Medicare, Medicaid and most insurance plans provide coverage for hospice care when physicians predict a patient has six months, or less, to live and curative treatment is no longer being sought. Please understand that the six-month prognosis is merely a guideline. Hospice re-evaluates patients every 60 days and, as long as their conditions continue to decline, they are re-certified for hospice coverage for as long as they live.

     Not always. Many physicians hesitate to broach the subject of hospice because they don't want to destroy your hope. Frequently, they will continue to pursue treatment because they assume that's what you want. In other cases, such as congestive heart failure or COPD, it is difficult for them to predict the rate of a patient's decline. When a doctor does mention hospice, even casually, you should discuss it immediately. In fact, he or she may actually be relieved if you bring up the subject. It is important that you understand the benefits of curative vs. comfort care, and that you and your doctor share the same goals for maintaining quality of life.

• An increase in pain, nausea, breathing distress or other symptoms
• Repeated hospitalizations or trips to the ER
• Failure to "bounce back" after medical set-backs occur
• Increasing assistance needed for walking, eating, bathing, dressing and/or going to the toilet
• Decreasing alertness--patient is emotionally withdrawn, sleeping more or having increased difficulty with comprehension

• You are physically and/or emotionally exhausted from caring for your loved one
• Your family is feeling isolated because of care-giving demands or the uncertainties you feel about your loved one's future
• The patient or members of your family appear to need emotional support to cope with the impending death
• You are overwhelmed by the myriad of physical, financial, emotional, and spiritual concerns arising because of the illness.

     Yes. Patients always have the right to choose what type of care they receive. If they and their physicians decide to try another approach, we will assist them in making that transition.

     Absolutely. An important part of our mission is providing guidance to families about any end-of-life care issue, whether or not they're on our program. You don't need a physician referral to call us for information. if it appears that hospice care would be beneficial, we will--with your permission--contact your doctor to discuss it.

     Family members are usually able to safely care for a hospice patient at home with the help of the hospice team. If the patient wishes to remain at home and the family desires more care than the visiting hospice staff can provide, we can offer a list of agencies providing private duty or companion care at home. Hospice does not cover these services. Serenity Hospice can provide a list of extended care facilities in the area.

     In the early weeks of care, it may not be necessary for someone to be with the patient all of the time. Many patients are physically and mentally capable of living alone and can manage with intermittent visits by the hospice team. As the illness progresses, the patient may require more assistance. The hospice staff assesses the patient's needs on an ongoing basis and makes appropriate recommendations.