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Electing and Revoking Hospice Care

What is hospice?

Hospice is a program of care for the terminally ill. The goals of hospice care are to provide comfort to the patient and support to the patient’s family. Core hospice services include medical care, nursing care, medical social services and counseling. Hospice provides medical equipment and medications related to the terminal diagnosis. Many patients and families also receive services from hospice volunteers, therapists and home health aides.

In New Jersey, hospice is defined as care provided by an agency licensed for hospice by the State of New Jersey and certified for hospice by Medicare.

Isn’t hospice a house, a place, a facility?

No. Hospice is a kind of care, specifically comfort care for the terminally ill. The vast majority of hospice care is provided in the home of a patient or a family member, or in a long term care facility (nursing home). In New Jersey, hospice care is also available in a small number of hospice residences and hospice units in hospitals. New Jersey law allows hospice care to be delivered without regard to a patient’s residence.

FYI, the concept of hospice as a “place” grew from the Middle Ages, when a “hospice” was a way-station for travelers to rest, and also where people with end-stage illness were brought to die. In England and much of Europe since the 1960s, hospice care has usually been delivered in free-standing hospice houses or hospice units in hospitals. In the U. S., however, hospice seeks to satisfy most patients’ desire to spend their final months in their own home, whenever possible.

If I elect hospice, will I die soon?

To be admitted to hospice care, the patient must be certified by two physicians as having a terminal illness and a life expectancy of six months or less. In electing hospice care, the patient is merely acknowledging that he or she is seeking comfort rather than cure.

Further, hospice does not “cut off” at the end of the six-month prognosis. Some patients live well beyond their original six-month prognosis, and hospice care may continue as long as the physician continues to certify a six-month life expectancy, the patient wishes to continue and the hospice believes the patient requires the services.

What hospice can guarantee is that by electing hospice earlier rather than at the last minute, you will be providing yourself and your family with access to a wide range of helpful services.

Can anyone receive hospice services?

Hospice services are available to all persons regardless of age, gender, race, religion, ancestry, citizenship, veteran status, marital status, sexual preference or mental or physical handicap. The only requirement for admission is that two physicians must certify your life expectancy of six months or less.

Payment for hospice services is available through Medicare Part A, New Jersey Medicaid, many private insurers and managed care policies, and private-pay. If none of those options are available, contact the hospice when you are ready to elect and explain your financial situation to the hospice staff member.

How do I qualify for hospice care?

A patient will qualify for hospice care if two doctors sign a document that a patient is terminally ill and is expected to live less than six months. One of these doctors is the patient’s own physician; the other is the hospice medical director. This is the sole medical requirement for admission to hospice.

The patient must sign an election of hospice care, in which the patient says he or she is no longer seeking curative treatment and instead seeks care for comfort.

Payment for hospice care can be made in many ways. The patient and family should discuss this with the hospice before electing hospice care. About two-thirds of New Jersey hospice patients receive hospice care through Medicare Part A.

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Boomers Resource Guide is a special supplement to the Senior Citizen's Guide