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Hospice vs. Hospice At Home

Hospice refers to the provision of health-related services aimed at
providing a high level of comfort and care until end of life. Hospice
care can be provided at a facility or at home. In order to qualify for
hospice care, the patient's doctor, and often a hospice doctor as well,
of six months or less.

Many people may not know that their loved ones can receive hospice
care in the comfort of their home. When a doctor refers a patient to
hospice care, the family can elect to have this care provided at a facility
or in a home (either the patient's or another care-giver/family member's
home). Regardless of the choice, look for an accredited hospice facility.
Accredited home healthcare providers usually maintain relationships with facilities to smoothly transition from providing home healthcare or hospice at home to a facility. Some home healthcare providers furnish hospice care as a part of their home healthcare offerings.

The level of Hospice Care

According to Medicare, there are four levels of Hospice care: 

>> Level 1 - Routine Home Care is the basic hospice level of care and usually includes:

  • Nursing services

  • Physician participation

  • Social services

  • Home health aide services

  • Counseling services (pastoral, spiritual, bereavement, dietary, and others)

  • Medications

  • Medical equipment

  • Medical supplies

  • Lab and diagnostic studies related to terminal diagnosis

  • Therapy services

>> Level 2 - Continuous Home Care ensures a nurse and/or a home health-aid will remain in the patient's home environment for eight to 24 hours per day and is reevaluated every 24 hours. Some examples of symptoms requiring continuous care would be:

  • Unrelieved pain

  • Severe nausea and vomiting

  • Severe shortness of breath

  • Anxiety or panic attacks

  • A breakdown in the primary caregiver support system

>> Level 3 - General Inpatient Care is available to patients who have short-term symptoms so severe they cannot get adequate treatment at home or may feel more comfortable getting treatment at an inpatient facility. Symptoms requiring inpatient care are the same as those requiring continuous care, only the setting of care may be different. 

>> Level 4 - Respite Care services are more for the caregivers/family members than for the patient. If the patient does not meet criteria to qualify them for continuous care, but the family is having a difficult time, respite care may be an option. If a patient’s family is the primary source of care and cannot meet their loved one's needs due to caregiver stress or other extenuating circumstances, a patient may temporarily receive in-home hospice care or be admitted to an inpatient environment to give the family respite. Note: There is a five-day limit on respite care. Once that period expires, the patient is discharged and returns home.

Keep in mind that Medicare does not always cover all of these services. Be sure to ask potential home healthcare agencies what is covered and what is not covered. We hope this directory will help make finding a caregiver easier.

>> Find a caregiver near you.

>> Learn how accreditation matters, affecting quality of care and more.

>> Learn the difference between certification and accreditation.


Published August 2019

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