Hospice care is usually offered in the person's home, with the hospital as a backup if needed. Hospice care is not appropriate for the newly diagnosed person unless the disease is so far advanced when it is discovered that the person does not want active treatment. Most people, at diagnosis, do begin to receive treatment.
If you want hospice care and your doctor agrees, you will be referred either to a hospital- based or community-based (home-care) program. Free-standing (inpatient) programs are not widely available in this country, although some do exist. Hospice care is characterized by a team approach designed to meet your physical, emotional, and spiritual needs. Hospice programs are staffed with doctors, nurses, aides, counselors, clergy, volunteers, and therapists. After an evaluation of your medical and emotional needs, you, your family, and the team will plan what services you need. Care is available 24 hours a day, seven days a week. If a hospice team member is not in your home, you will be able to reach someone by phone whenever you want assistance. When a person dies, supportive help is often available for family members.
Services are paid for by the Medicare hospice benefit (if the hospice is Medicare-certified) and by many private insurance companies, usually under the home-health-care benefit. Each agency has its own policies regarding payment, so it is best to check with them.
Hospice services are available in many but not all communities. If no hospice services are available in your community, your health-care team should see that all existing services are coordinated to help you remain as comfortable as possible.