While many people think that hospice is a place, hospice care is actually a specialized type of care for those with a terminal or life-limiting illness that patients receive wherever they call home – including assisted living facilities and nursing homes.

Hospice care provides months of care and support to improve quality of life by managing pain, symptoms, and anxiety. An interdisciplinary team provides physical, emotional, and spiritual care – delivering a whole-body approach to care. Patients care plans are individualized based on what is most important to them at this time of their life.

How hospice care helps nursing home residents

While nursing home staff are experts in custodial care, hospice care team members are experts in end-of-life care for nursing home residents living with life-limiting or terminal illnesses who have a life expectancy of six months or less. 

Hospice care offers residents:

• Regular visits by a Registered Nurse and hospice aide
• Consultations by a hospice physician as needed
• A care team focused on pain and symptom management
• Reduction of hospitalizations, re-admissions, and emergency room visits
• Extra spiritual and emotional care and support 
• Any additional medications or medical supplies needed related to the hospice diagnosis
• Coordination of care between all the patient’s doctors, nursing home staff and hospice care team members
• Education for nursing home staff, the patient and their family members about the patient’s condition, symptoms, medications, and how to provide the best medical care for the resident at this time of their life
• Grief care for 13 months for family members after the death of their loved one

Don’t nursing homes provide hospice care?

While some nursing homes may have small hospice units with specialized staff, most choose to partner with hospice providers because of their expertise in this type of care. The care provided is complimentary to that being provided by the nursing home, thereby ensuring the best possible end-of-life care for their residents.

How is hospice care paid for in a nursing home setting?

The Medicare Hospice Benefit covers the cost of hospice care for those residents who qualify:

• A doctor and medical director certify that the resident has a life-limiting or terminal illness with a life expectancy of six months or less.
• The resident signs a statement electing hospice care and stops receiving treatment for their terminal illness. This, of course, does not stop them from receiving care for other medical conditions they may have.
• The resident can stop hospice care and restart receiving treatment for their illness at any time they desire.
• The nursing home has a contract with a Medicare approved hospice provider. Lower Cape Fear LifeCare is a Medicare approved provider with a history of being recognized for exceptional care.

Keep in mind that the hospice benefit does not pay for housing costs associated with nursing home care but for the care, supplies and medications provided by the hospice agency. 

What are the nursing home’s responsibilities?

In additional to routine daily care and regular medical care and medications provided by the nursing home, the nursing home staff will

• Communicate and coordinate with the hospice care provider for the patient’s care
• Monitor the patient’s condition and notify the hospice care team of any changes

How do I find out about getting hospice for myself or a loved one in a nursing home?

Lower Cape Fear Hospice partners with more than 40 nursing homes and assisted living facilities throughout its service area. Of course, who provides a patient’s hospice care is always their choice. If you or a loved one need hospice care in a nursing home, ask to speak to a representative from Lower Cape Fear LifeCare to find out more about our services and team.
You can also contact us directly to get more information at 800-733-1476.

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Kelly Erola, MD, FAAHPM, FAAFP, is currently the Chief Medical Officer for Lower Cape Fear LifeCare, based in Wilmington, NC, where she has worked since 2017. Previously, she was Chief Medical Officer for Hospice Savannah, Inc. for 16 years and physician leader of the Steward Center for Palliative Care. Dr. Erola is board certified in hospice and palliative care medicine and has been involved full-time in palliative care since 2002.