What Are Hospice Services? An Interview with Amy Tucci

Amy Tucci is the President and CEO of Hospice Foundation of America, headquartered in Washington D.C . She oversees organizational programming, manages and raises funds for the hospice services organization. Before arriving at Hospice Foundation of  America, Amy was a  former journalist and communications professional who worked for a long-term care and hospice provider. Through her past and current work, Amy has helped to educate others on exactly what hospice services are.

Amy Tucci

Jeanette: What are the reasons why people wait to call hospice in?

Amy: People don’t quite understand the nature of hospice care. People often associate hospice care with death when they should, in fact, associate it with quality of life towards — as opposed to at — the end of life. They think of hospice as “the final frontier.”  In other words, they equate hospice care with dying and look upon seeking out hospice care as an “admission of defeat” — “surrendering” to imminent death.  Thus, family members — as well as medical physicians who have made it their mission to cure their patients — often don’t want to consider the possibility.

About 44% of people dying in America are dying in hospice care.  The problem is [that] physicians are calling 911 for hospice; they are waiting until their patients are very close to death before transitioning them into care that is not curative. A lot of people don’t realize that one can reap the many benefits of hospice care for over six months (as opposed to a week or a few short days) before he or she passes.  If placed in hospice early enough, one could conceivably attend a wedding, a graduation ceremony, go on a trip, etc. while receiving care.

Amy’s 5 Insights into Hospice Care

1) Although most hospice patients are over 65 years old age, hospice applies to anyone at any age.

2) Sometimes, people are discharged from hospice care because their condition actually improves once they’re removed from chemotherapy, hospital settings, etc.

3) Contrary to popular misconception, hospice care is not only for people who are terminally ill with cancer.  Many people in hospice are dying from heart disease, heart failure, neuro-degenerative diseases, Parkinson’s Disease, Alzheimer’s, renal failure, “debility unspecified,” etc.

4) Hospice provides patients’ family members/loved ones with resources for grief and bereavement support.

5) Hospice also provides grief/bereavement support services to people whose loved ones died outside of hospice care.  This includes support for community members coping in the aftermath of public tragedies.

Jeanette: What are the different types of hospice care?

Amy: There are three different types of hospice care:

* Care in the patient’s place of residence (a personal home or apartment, a nursing home, an assisted living facility, etc.).  No member of any given patient’s hospice team (generally consisting of medical physicians, nurses, social workers, volunteers and — if requested — members of the clergy) is at his/her bedside 24 hours a day.  However, the members of the hospice team are available for visits as needed.

* Crisis management (short-term care when problems occur at the patient’s place of residence).

* Residential care, in which patients live in a hospice facility (basically the equivalent of a luxurious nursing home).

A common misconception is that hospice does not offer for 24-hour care. Two thirds of patients today receive care at their place of residence, where many are, in fact, most comfortable.  Meanwhile, 25-26% of patients pass away in inpatient hospice facilities.

Credit: HopeHealth

Jeanette: How long do most people employ hospice care? How long do they qualify for that care?

Amy: In 2011, roughly 36% of patients received hospice care for seven days or fewer.  [Around] 27% of patients received hospice care for about a week to 29 days; 17% of patients received hospice care for 30-89 days; nine percent of patients received hospice care for 90-179 days; 11% of patients received hospice care for 180 days.

“If placed in hospice early enough, one could conceivably attend a wedding, a graduation ceremony, go on a trip, etc. while receiving care.”

One can receive hospice care for six months. After that six-month period, the patient may qualify for an extension of up to twelve additional months of care (two more six-month cycles). A physician [must] re-certify him/her as “terminally ill.”

Jeanette: What’s the best way to organize hospice care for yourself or a member of your family?

Amy: One way to get into hospice is to obtain a physician’s referral.  Alternatively, a patient or a family member/loved one could contact a local hospice [facility] (no singular entity delivers hospice; there are over 4,000 facilities throughout the U.S.). A reviewer affiliated with the facility of choice will then evaluate the patient’s case.

Jeanette: Who pays for hospice? What are the costs to the person using hospice?

Amy: The vast majority (83-84%) of [hospice] patients are Medicare-eligible. Medicare covers every cost of hospice. Manage care/private insurance is the second payer. Medicaid pays as well. Charity care is available to people who are not declared eligible and have no other means to pay.

Jeanette: Thanks, Amy!

Amy: Thank you.

Related

• 10 facts about hospice care you may not know
• Elder Care Locator: Connecting You to Community Services
• International Association for Hospice & Palliative Care