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Understanding healthcare at home can be difficult.

- Even for the people who work in the industry!


When the time comes for you to make the hard decisions for yourself, your loved ones, or anyone in your life - you want to have the know-how to do so.

We want to help.

- So let's start with the basics.

 

What is hospice?

Hospice care is a type and philosophy of care that focuses on the terminally ill or seriously ill patient's pain and symptoms, and attending to their emotional and spiritual needs. Within the U.S. hospice care is available either in an inpatient facility or at the patient's home, for patients with a terminal prognosis who are medically certified to have less than six months to live.

What is home care?

Home care aims to make it possible for people to remain at home rather than use residential, long-term, or institutional-based nursing care. Home care providers deliver services in the client's own home. These services may include some combination of professional health care services and life assistance services.

Professional home health services could include: medical or psychological assessment, wound care, medication teaching, pain management, disease education and management, physical therapy, speech therapy, or occupational therapy. Life assistance services include: help with daily tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship.

Home care can be an integral component of the post-hospitalization recovery process, especially during the initial weeks after discharge when the patient still requires some level of regular physical assistance.

What is palliative care?

Palliative care is an area of healthcare that focuses on relieving and preventing the suffering of patients. Unlike hospice care, palliative medicine is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life.

Palliative medicine utilizes a multidisciplinary approach to patient care, relying on input from physicians, pharmacists, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life.

This multidisciplinary approach allows the palliative care team to address physical, emotional, spiritual, and social concerns that arise with advanced illness.

 

Hopefully, now you have a bit more of an understanding.

Let's take a more in-depth look into what you might need.

 


 
How Hospice Works- via Medicare.gov:

Your doctor and the hospice team will work with you and your family to set up a plan of care that meets your needs. Your plan of care includes hospice services that Medicare covers. For more specific information on a hospice plan of care, call your national or state hospice organization.

If you qualify for hospice care, you'll have a specially trained team and support staff available to help you and your family cope with your illness.

You and your family members are the most important part of a team that may also include:

  • Doctors
  • Nurses or nurse practitioners
  • Counselors
  • Social workers
  • Physical and occupational therapists
  • Speech-language pathologists
  • Hospice aides
  • Homemakers
  • Trained volunteers

In addition, a hospice nurse and doctor are on-call 24 hours a day, 7 days a week, to give you and your family support and care when you need it.

A hospice doctor is part of your medical team. Your regular doctor or a nurse practitioner can also be part of this team as the attending medical professional to supervise your care. However, only your regular doctor (not a nurse practitioner that you’ve chosen to serve as your attending medical professional) and the hospice medical director can certify that you’re terminally ill and have 6 months or less to live.

The hospice benefit allows you and your family to stay together in the comfort of your home unless you need care in an inpatient facility. If the hospice team determines that you need inpatient care, the hospice team will make the arrangements for your stay.

Where do I get hospice care?

Most hospice patients get hospice care in the comfort of their home and with their families. Depending on your condition, you may also get hospice care in a Medicare-approved hospice facility, hospital, nursing home, or other long-term care facility.

How long can I get hospice care for?

Hospice care is intended for people with 6 months or less to live if the disease runs its normal course. If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor recertifies that you’re terminally ill. Hospice care is given in benefit periods.A benefit period starts the day you begin to get hospice care and it ends when your 90-day or 60-day period ends.

  • You can get hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods
  • You have the right to change providers only once during each benefit period
  • At the start of each period, the hospice medical director or other hospice doctor must recertify that you’re terminally ill, so you can continue to get hospice care

How do I find a hospice program?

Consider these questions when selecting hospice care providers:

  • Is the hospice program certified and licensed by the state or federal government?
  • Does the hospice provider train caregivers to care for you at home?
  • How will your doctor work with the doctor in the hospice program?
  • How many other patients are assigned to each member of the hospice care staff?
  • Will the hospice staff meet regularly with you and your family to discuss care?
  • How does the hospice staff respond to after-hour emergencies?
  • What measures are in place to ensure hospice care quality?
  • What services do hospice volunteers offer? Are they trained?

The hospice program you choose must be Medicare-approved to get Medicare payment. To find out if a certain hospice program is Medicare-approved, ask your doctor, the hospice program, your state hospice organization, or your state health department.

What if I'm in a Medicare Advantage Plan or other Medicare health plan?

All Medicare-covered services you get while in hospice care are covered under Original Medicare, even if you're in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan. That includes any Medicare-covered services for conditions unrelated to your terminal illness or provided by your attending doctor.

How do I care for my other conditions?

You should continue to use Original Medicare to get care for any health care needs that aren't related to your terminal illness. You may be able to get this care from the hospice team doctor or your own doctor. The hospice team determines whether any other medical care you need is or isn't related to your terminal illness so it won't affect your care under the hospice benefit.

You must pay the deductible and coinsurance amounts for all Medicare-covered services. You must also continue to pay Medicare premiums, if necessary.

How do I stop hospice care?

  • If your health improves or your illness goes into remission, you no longer need hospice care
  • You always have the right to stop hospice care at any time for any reason
  • If you stop your hospice care, you'll get the type of Medicare coverage you had before you chose a hospice program (like treatment to cure the terminal illness)
  • If you're eligible, you can go back to hospice care at any time
 


 

How Home Health Care Works - via Medicare.gov:

Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services like intermittent skilled nursing care, physical therapy, speech-language pathology services, continued occupational services, and more. Usually, a home health care agency coordinates the services your doctor orders for you.

Medicare doesn't pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Homemaker services
  • Personal care

Who's eligible?

All people with Medicare who meet all of these conditions are covered:

  • You must be under the care of a doctor, and you must be getting services under a plan of care established and reviewed regularly by a doctor.
  • You must need, and a doctor must certify that you need, one or more of these:
    • Intermittent skilled nursing care (other than just drawing blood)
    • Physical therapy, speech-language pathology, or continued occupational therapy services (covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally-predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition.)
  • The home health agency caring for you must be Medicare-certified.
  • Your must be homebound, and a doctor must certify that you're homebound.

You're not eligible for the home health benefit if you need more than part-time or "intermittent" skilled nursing care.

You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.

Note:

Home health services may also include medical social services, part-time or intermittent home health aide services, medical supplies for use at home, durable medical equipment, or injectable osteoporosis drugs.

Note:
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs.
 


 

How do I know what services I need?

Many times, discussing options with your doctor, therapists, or peers can help to guide you towards the right care option for your needs. Each persons needs will be different, but that is the beauty of healthcare at home. Our professionals perform thorough tests to ensure each client's safety and comfort in the location they choose - to ensure the best care is provided. Oftentimes, you can speak with the helpful employees at each agency you consider - they are a wealth of experience and knowledge which can ensure you receive the service best-tailored to your situation.

How can I find an agency in CT?

We have a fantastic tool which allows you to search for agencies with the proper specialties, services, and locations you might be looking for. Click here to begin searching.

How can I make sure an agency is legitimate?

On our website, we have collected a number of resources to help you thoroughly investigate agencies you might be considering. You can see them on this page. You'll also want to consider proceeding through the checklist we outlined on our page How do I Select the Right Home Care Provider?

Can I call/visit/email agencies for more information?

Absolutely! Each agency will more than likely have a website with contact information, hours, and locations so that you can get a more in-depth look into the organization you may be interested in. If you can't find what you're looking for through our Agency Search, you can also call us for contact information. Site visits, consultations, and phone inquiries are a great way to get more comfortable with the process and ease into the new chapter in your life - and the lives of those most important to you.

There are a lot of service specialties. How do I know which one is right for my situation?

We have a great guide to Hiring a Caregiver, which helps to show the different facets of the specialties under the umbrella of healthcare at home.



Looking for more information? You can contact the Department of Public Health, the Department of Social Services, or local agencies for help with more in-depth provider questions. To search for providers in certain areas, or specializing in certain services, click here. You can see a full list of Association members here as well.

We hope this information has been a beneficial addition to your search!

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