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When should a decision about entering a hospice program be made — and who should make it?

At any time during a life-limiting illness, it's appropriate to discuss all of a patient's care options, including hospice. By law, the decision belongs to the patient.

Should I wait for our physician to raise the possibility of hospice, or should I raise it first?

The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.

What if our physician doesn't know about hospice?

Most physicians know about hospice. If your physician wants more information, it is available from the American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local hospices, or the National Hospice Helpline, 1.800.658.8898. In addition, physicians and all others can obtain local information from Sparrow Hospice Services at 1.888.636.8236.

Do you have continuity with the hospice staff that comes to the home?

The Home Hospice patient has a Registered Nurse Case Manager and a Social Worker assigned that follow them through their illness. We try to maintain the same aides but they may change dependent on the time and day the patient and family choose for care. Volunteers are assigned to a patient and family and are not changed throughout the illness unless the family requests a change. The Hospice House has a 24/7 staff. We try to maintain as much continuity as possible.

How is Sparrow Hospice Services different from other hospices?

Sparrow Hospice Services are the most comprehensive hospice programs in the mid-Michigan area. Our hospice cares for people in their homes in the following counties: Ingham, Eaton, Clinton, Ionia, Gratiot, Montcalm as well as parts of Shiawassee and Jackson.

We have contracts with six nursing homes: Burcham Hills, Hazel Findlay, Ovid Health Care Center, Laurels of Carson, Tendercare West and Okemos Health and Rehabilitation.

Sparrow Hospice Services also offers Hospice House of Mid-Michigan. Hospice House of Mid-Michigan is the only Medicare-Medicaid certified in-patient facility in mid-Michigan. Because of these credentials many insurances will pay for your stay at Hospice House. Hospice House of Mid-Michigan takes referrals from virtually any place in the world.

It is not uncommon for family members that live in the mid-Michigan area to have their loved one that lives in another state transferred to Hospice House of Mid-Michigan so they can be near them.

What active symptoms do you treat?

We treat all symptoms that cause the patient to be uncomfortable. Our goal is to make each day as comfortable for the patient as possible. Common symptoms are pain, nausea, anxiety, and insomnia.

Can a hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive therapy or go on about his or her daily life.

If a discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.

What does the hospice admission process involve?

One of the first things hospice will do is contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Hospices may have medical staff available to help patients who have no physician). The patient will also be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.

The "hospice election form" says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.

Is there any special equipment or changes I have to make in my home before hospice care begins?

Sparrow Hospice Services will assess your needs, recommend any necessary equipment, and help make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the disease progresses.

In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

How many family members or friends does it take to care for a patient at home?

There's no set number. One of the first things a hospice team will do is prepare an individualized care plan that will, among other things, address the amount of care-giving a patient needs. Hospice staff visits regularly and is always accessible to answer questions and provide support.

Must someone be with the patient at all times?

If hospice determines the patient is unsafe at home they will request the patient have someone with them 24 hours/day.  If the patient is restless and unsafe at Hospice House, hospice will request help from the family to keep the patient safe 24 hours a day.

While family and friends must be relied on to give most of the care, hospices do provide volunteers to assist with errands and to provide a break and time away.

How difficult is caring for a dying loved one at home?

It's never easy and sometimes can be quite hard. Near the close of a long, progressive illness, nights especially can be very long, lonely and scary. So, hospices have staff available around the clock to consult with the family and to make night visits as appropriate.

What specific assistance does hospice provide home-based patients?

Hospice patients are cared for by a team of doctors, nurses, social workers, home health aides, clergy, therapists, and volunteers. Each provides assistance based on his or her area of expertise. In addition, hospices help provide medications, supplies, equipment and additional helpers in the home, as appropriate.

Does hospice do anything to make death come sooner?

Hospices do nothing either to speed up or to slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice offers its presence and specialized knowledge during the dying process.

Is the home the only place hospice care can be delivered?

No. Although most hospice services are delivered in a personal residence, some patients live in nursing homes. Sparrow Hospice Services also has a residential living environment called Hospice House of Mid-Michigan.

How does hospice "manage" pain?

Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and symptom relief. Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain. Counselors, including clergy, are available to assist family members as well as patients.

What is hospice's success rate in managing pain?

Sparrow hospice uses a multiple modality approach to helping manage pain for our patients to including medications, counseling and therapies.

Will medications prevent the patient from being able to talk or know what's happening?

Usually not. It is the goal of hospice to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, hospices have been very successful in reaching this goal.

Is hospice affiliated with any religious organization?

Hospice care is not affiliated with any religion. While some religious organizations have started hospices (sometimes in connection with their hospitals), Sparrow hospice programs serve a broad community and do not require patients to adhere to any particular set of beliefs.

Is hospice care covered by insurance?

Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in Michigan, and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?

The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, Sparrow Hospice Services will provide care for those who cannot pay, using money raised from the community or from memorial or foundation gifts.

How soon can the service be started?

Hospice service can begin immediately after the patient and family have heard about the program through a process called informed consent and agreed to be admitted to hospice. A physician must order hospice care before the program can start.

What can the volunteer do?

The volunteer can do anything that is mutually agreed upon with the patient and the family and planned by the hospice RN case manager.

Does hospice provide any help to the family after the patient dies?

Hospice provides continuing contact and support for family and loved ones for at least a year following the death of a loved one. Sparrow Hospice Services also sponsors bereavement and support groups for anyone in the community who has experienced the death of a family member, a friend, or a loved one.

If the patient is eligible for Medicare, will there be any additional expenses?

Medicare covers services and supplies related to the terminal illness for the home hospice patient. Medicare pays for the hospice care provide at Hospice House. However, there may be a room and board charge dependent on the patient’s health care insurance.

What is your service area?

Sparrow Hospice Services cares for the terminally ill throughout the mid-Michigan area.