1. Who is on a hospice care team?
 

Meeting the challenge of caring for a person at the end of their life would be daunting for anyone. Few people would have the resources necessary to retain a care provider, a social worker, a chaplain, CNAs and others. Even if they did, without a true team structure in place, communication and coordination of care would be difficult.

 ProCare Hospice’s team structure alleviates that burden. With a dedicated and coordinated team of professionals who understand and meet the changing needs of a patient with a terminal illness, the end of life can become a dignified and compassionate process. 

What does each hospice care team member do?

Provider — The care provider, a physician or nurse practitioner, is responsible for the patient’s overall care and for creating the individualized care plan.  Providers should be hospice and palliative care certified, to ensure the patient and family receive the best possible care.

Nurse — An RN or LPN functions as the patient’s case manager. They ensure that a patient’s physical condition is closely monitored and that pain and symptoms are properly managed.

Hospice Aide — Aides perform vital day-to-day functions, assisting patients with activities that their disease may hamper, such as bathing and shaving. They also assist with mobility issues, such as leaving the bed.

Social Worker — Social workers assess each patient and family situation to find and coordinate any support needed. Social workers are knowledgeable about the community resources to help with any financial, legal or other issues.

Volunteer — Volunteers provide an additional layer of support in various ways — from delivering meals to being a companion, they are there to help.

Chaplain — At the end of life, spiritual matters often come into focus. Non-denominational chaplains are available for spiritual support and they can also coordinate with a patient’s church to provide extra pastoral assistance.

Bereavement Specialist — Hospice doesn’t end with the passing of the patient. Grieving takes time and bereavement specialists work with family and loved ones to guide them through the process. 

Child Life & Therapeutic Services — If appropriate, Specialty Services are included in the team based on the patient and family’s need. These can include a Child Life Specialist, massage therapist, aromatherapy, pet therapy, energy healing and other non-pharmaceutical methods to manage symptoms when possible.

How many visits does a hospice care team make?

Members of the ProCare team visit a patient as many times a week as necessary. Since each team member is constantly briefed on a patient’s progress and changing needs, no matter which team member visits, they can relay needs or requests.

As a person’s condition changes, different team members may adjust their visits to more or less, as appropriate. 

What happens if I need someone after hours?

No disease works on a nine-to-five schedule.  ProCare Hospice is always only a call away, 24/7. A clinical expert is always available to assess the situation, provide advice or dispatch a clinician as needed.

What’s different about the ProCare Hospice care team?

We are a family-run hospice. We understand the burdens and pressures that accompany the end of life. We know your family and loved ones want to be treated like family, not a medical chart.

Our CEO is also our Chief Medical Officer and has been hospice-certified for over 10 years. Pain and symptom management are at our core, but we understand care doesn’t happen in a vacuum. A patient’s emotional, mental and spiritual needs are closely tied to their physical condition. We provide a team of experts to make sure the patient and their loved ones are treated like family by our family. 


2. What should I expect from hospice care?


Most people never think about hospice until the need is urgent. Once a care provider mentions hospice, you may not understand what it involves, why you or a loved one need it and how can you make such an important decision during what is typically one of the most stressful times of life. 

While hospice care can include many aspects, the easiest and most critical thing to understand is, hospice care focuses on comfort, dignity, and all-around support for the patient with a terminal illness.  Whether you are deciding on hospice for yourself or a loved one, it can be a challenge to understand it all. The ProCare Hospice team has decades of experience in hospice, and we understand how overwhelming it can be. We’ve tried below to answer some of the most common questions about what happens when a person decides to begin hospice care.

Why did my doctor suggest hospice?

A physician is most often the one who will refer a patient to hospice. A care provider understands the patient’s symptoms, the progression of the disease and ultimately, the prognosis of how long, if the disease progresses typically, the patient will live.

Recommending hospice means a provider thinks the person will benefit more from a shift in the focus of care from curing the disease to managing the symptoms. Instead of continuing to pursue treatments that are no longer effective, comfortable or desired (for example, chemotherapy), hospice focuses on the physical, mental, emotional and spiritual comfort of the patient, as well as the family and loved ones. Pain and symptom management become the priority, in order to improve the quality of life for as long as possible.

People often think of hospice as “giving up.” Hospice is actually about the quality of the person’s life. We truly believe that it’s not the amount of days in your life, but the amount of life in your days.

Is the doctor the only one who can refer me to hospice?

Not at all. Many referrals come from medical case workers, friends, family members, chaplains or social workers, and even patients themselves. A doctor’s prognosis of six months or less left to live is needed to receive hospice care and we encourage people to begin hospice as soon as possible. The earlier you begin care, the more benefits a hospice care team can provide.


What happens when I first sign up for hospice?

The hospice care team arranges a comprehensive consultation with the patient and loved ones. The purpose of the meeting is for the hospice team to fully understand the patient’s goals and needs for care. Hospice care most often includes goals from all four of these areas:

Physical: Most physical goals are to live as pain-free, mobile and alert as possible as the disease progresses. 


Mental: Everything from legal issues, financial burdens and insurance impacts a patient’s mental state and the goals are often to reduce or relieve that impact. 

Emotional: Feeling capable physically isn’t as helpful unless depression, anxiety and stress are also dealt with  — for both the patient and their family and loved ones.

Spiritual: Spiritual goals can be more critical than others for many people, and it’s important to make sure those are addressed for each patient, family and community.

Who pays for hospice care?

Most hospice care is completely covered by Medicare and most major insurances. In the rare cases it is not, most hospices (like ProCare) have a charitable foundation, to cover the costs of hospice, so no one is left to deal with the challenges of the end-of-life process by themselves.
 

Do veterans need specialized hospice care?

Sometimes, but not always. ProCare Hospice is partnered with the We Honor Veterans program in association with the VA. We employ veterans and we understand that, especially at the end of life, veterans have specialized needs.

We maintain a unique veterans’ room in our facility, to make sure we properly honor and care for those who have served our country.
 

What does a hospice care team do for me or my loved one?

The first step after a hospice consultation is to create a unique Care Plan. The patient’s physician or specialist is invited to participate as the hospice care team works to create an individual road map. The goal of the Care Plan is to ensure the patient’s comfort physically, mentally, emotionally and spiritually.
 

The Care Plan creates the guidelines for coordinating medication or equipment, scheduling regular nursing visits, day-to-day assistance with bathing and other needs, as well as support from social workers and spiritual advisors. Additionally, other needs, such as pet therapy, music therapy, and bereavement counseling are included.
 


Does hospice provide equipment and medication?

Yes, but only the ones related to the terminal illness diagnosis. In other words, if you had glasses and needed new ones, hospice benefits from Medicare or other insurance would not cover new glasses. However, any pain medication or equipment related to your cancer      would be covered.

Medications and medical equipment are delivered and set up wherever the patient calls home. The goal is always to reduce stress and worry for the patient and loved ones, and ensure their precious time can be spent together, not driving to pharmacies.

What happens near the end of life?

We strive to keep patients where they are most comfortable and this is usually at home. As a patient declines, members the hospice care team may increase or decrease the number of visits as appropriate. Medications may increase. ProCare Hospice maintains a comfortable, home-like 14-bed inpatient unit, in case a patient’s symptoms need 24-hour care.
 

What happens after my loved one is gone?

Primary hospice care may be over, but for those left behind, hospice is still there to support. ProCare Hospice maintains a Bereavement Counseling program to assist with those grieving. Support groups and other resources are available for family members and loved ones to guide them through the rough months ahead.

Why should I use ProCare Hospice?

We are family-owned and operated. We celebrate families of all kinds. Our philosophy is to treat your family like our own family.
 


3. What is involved with a hospice care consultation?


Why is someone from hospice calling me?

There’s no getting around the fact that an initial discussion about hospice care can be challenging. Often, a patient or family member may not yet be aware      of the patient’s prognosis of six months or less to live. It can come as a shock to receive a call from a hospice admissions representative. Emotions during a first call can be high.

We understand. 

We believe in hospice care, because over the years, we’ve seen it help people again and again. We know it is difficult to accept at first. We are all human and understand that this is a difficult time for anyone.
 

A hospice admissions representative will help educate the patient and loved ones on what their options are. No one is ever forced to sign up for hospice. We are there to help you understand and make the right choice for you and your loved one.

What happens during a hospice care consultation?

A hospice care admissions representative will provide the patient and their loved ones with information about what to expect during hospice care, who pays for hospice care and answer any other questions they have.

The main goal of the consultation is to discover what the patient and family want. What does quality of life mean to someone who is dying? How can hospice help them achieve that quality of life? What will be expected of a caregiver day-to-day?

Only by looking at and answering these questions can the patient and their loved ones understand what’s coming and what will be involved. Hospice care representatives are there to help, and will take as much time as you need to answer your questions.
 

What is an Advanced Directive and do I need one?

An Advance Directive is a legal document, outlining your wishes for medical care in case you are incapacitated and can no longer make decisions. We encourage everyone to have an Advanced Directive and to draft them earlier rather than later. If you make the decisions you want in advance in writing, your care team and others are legally-bound to follow them.

Some resources to understanding Advance Directives and POLST(Physician’s Order of Life Sustaining Treatment) and DNR(Do Not Resuscitate) are here.
 

How do I decide whether hospice is right for me or my loved one?

Of course, we believe hospice is right for anyone who is eligible. However, we encourage you to make sure you and your loved ones are comfortable with the decision. Not everyone in your life may be 100 percent onboard with each decision, which is why it’s important for a patient to make their wishes known in advance.

Ask questions. Research. Ask your care provider, family and friends. There are great resources online from NHPCO to understand what makes a good hospice provider. Look at Yelp or Google Reviews to find out people’s experiences with hospice in your area.

ProCare Hospice is always ready to answer your questions. Call 702-380-8300 or read more on our website click here about what hospice is, and what makes sense for you. We are family-owned and operated and we are always honored when you trust our family to take care of yours.



4. What should I expect from hospice care at home?


At this vulnerable time, when you or your loved ones may feel out of control, rest assured you are in control of your hospice care. 

After the hospice care team has created your unique care plan, the coordinator will schedule regular visits from the team members.  You can learn about the different roles of each team member here. Hospice care team members don’t show up all at once, and will space out their visits to make sure you or your loved one are cared for constantly, but not intruded on.

Why would I want to have hospice care at home?

Just as most people would prefer to recuperate from a flu or broken leg in the comfort of their home environment, most people with terminal illnesses would prefer to live out their days in the place they call home. Familiar surroundings, family photos, collections of keepsakes, can all contribute to a patient’s emotional and spiritual wellbeing during this difficult time.
 

What do I have to do when hospice care team members are at my home?

Whatever you want. Many caregivers are grateful for some respite, as caring for a terminally-ill loved one can be a burden. You may want to discuss symptoms with a nurse or spiritual questions with a chaplain. You may want to sit outside for a few minutes alone, knowing your loved one is in gentle and compassionate hands.
 

As a caregiver, it is without a doubt, a challenging time. But it can also be a beautiful one. Your care team is there to support you, answer your questions and at the same time, they will look to you for information, input and guidance. No one will know better than you and your loved one what symptoms and issues are faced day-to-day. 

What do I do if something goes wrong in the middle of the night?

Call 702-380-8300. ProCare Hospice is open 24/7. You will speak to a clinical expert, who can give advice or send a clinician out if necessary. 

We understand that you are in a role that is challenging and you need guidance and support. The ProCare Hospice team system is in place to update team members constantly and share up-to-date information with all team members. They are trained to look at the big picture and know what to look for as a disease progresses. They can tell you what it typical and often what to expect.

How long does hospice care at home take?

Hospice care at home varies, depending on the disease and the prognosis. The patient’s care plan will determine how many nurse visits per week, or nursing assistant visits per week are needed. The care plan is adjusted as the disease progresses, so that the patient’s physical, mental, emotional and spiritual needs are met.
 

If at any point, symptoms cannot be managed at home, ProCare Hospice maintains a comforting, home-like 14-bed inpatient units. 24/7 care of symptoms is available in the unit, which also contains family rooms,  recliner sleepers and other amenities.

ProCare Hospice is family-owned and operated. We celebrate families of all kinds and know how important the sense of “home” is for anyone, especially those at the end of their lives. We strive to care for our patients at home as much as possible. We know this allows for more time and memories with their loved ones, as well as the dignity and comfort of being in a familiar and secure environment.


5. What does it mean to refer a patient to hospice?


Once someone becomes eligible for hospice (read more here about who is eligible for hospice care, they can be referred to a hospice to begin care.  The process often begins with a physician or healthcare provider’s referral, but not always. Sometimes a case manager or social worker may feel a patient or assisted-living resident would benefit from hospice care and suggest a referral.
 

ProCare Hospice is family-owned and operated. We celebrate families of all kinds. We know there is only one chance to give a loved one a dignified and comforting end-of-life experience. Every day, we strive to make sure each patient and their families receive the respect and comfort they deserve on their last journey together.
 

Does a referral mean I or my loved one is committed to hospice?

No. We believe firmly that if someone is eligible, and has been referred, they will benefit from hospice care. However, the final decision is the patient and family’s. If you have been referred to hospice for yourself or a loved one, explore your options. Read more about accredited hospices through the National Hospice and Palliative Care Organization (NHPCO).

Understand what the benefits of hospice are. Ask questions of your provider, referrer or the suggested hospice. Ask friends or family members if they have had experience with hospice. Make sure you and your loved one are comfortable with the decision. 

I’m a doctor -  how involved will I be in my patient’s care after I refer them to hospice?

As much as you want. We know physicians and providers build strong relationships with those in their care. Our hospice care team will craft an individual Care Plan and we always encourage their provider to be a welcome part of the patient’s journey. 

I’m trying to plan out my wishes or a loved one’s wishes — If I call, will I get a sales pitch?

No. We are here to be a resource to you. While we feel the care we provide is unmatched, we understand sometimes you just need information. We also provide resources on our website, to help with planning, such as information on Advanced Directives and specialized care, like hospice for veterans or pediatric hospice.

However, we are here 24/7 to answer the questions you have. Hospice care is our passion and we want to be able to help you make the right decision for your family.

Call 702-380-8300 or send us an email.


6. What is an Advanced Directive?


An advance directive is a legal document that ensures your wishes will be followed when you receive care in the future, even if you are no longer be capable of making or communicating those decisions. While we wish everyone could retain mental clarity until the last minute of life, many times, this simply isn’t going to happen. Disease, as well as the management of severe pain symptoms, can prevent both mental clarity as well as the ability to communicate.

Planning and making your Advance Directive ensures your wishes for your care are followed. An Advance Directive usually appoints a person to have healthcare power of attorney, who can speak for you when you are no longer able to speak for yourself.  You do not need a lawyer to fill out your advanced directive, but you need to make sure you follow and comply with all the guidelines to ensure your advanced directive is valid. Click here for information on Nevada laws and an Advanced Directive template.

Why do I need an Advanced Directive?

There are many reasons to have one. First and foremost, you have peace of mind that your wishes for end-of-life care will be followed. You say exactly what you want and how you want to be cared for.

Second, it brings peace of mind to your family and loved ones. Having the difficult but necessary conversation with your family and signing your advanced directive, lets everyone involved know what you want out of your care at the end of life.
 

We know it is incredibly difficult to face decisions like whether or not you want life-sustaining treatments if you are in a coma, or whether you want a feeding tube if you can no longer eat. However, making those types of decisions now, while healthy and sound of mind, can impact you and your family greatly.

ProCare Hospice is family-owned and operated. We celebrate families of all kinds. Yet, we know that families don’t always agree. The stress and confusion about a loved one’s care at the end of life can put tremendous strain on family members. If a patient hasn’t decided what they want, different family members may have different ideas about what is best. While family intentions come from a place of caring, they may not align with what you want. With nothing formal written down, it can disrupt your care and the remaining time your family has with you.

What kind of things do I have to decide?

The Advanced Directive is critical for the hospice care team, so they know what you want. Do you want to stay at home at all costs, or only until your medical needs can no longer be met? Do you want to extend life as long as possible? Do you want to receive fluids and nutrition through a tube?
 

Of course, your hospice team will provide guidance to you and your family on best practices. However, depending on your beliefs and desires, you should be treated the way you wish.

Cultures and belief systems vary when it comes to care at the end of life. ProCare Hospice always respects a patient’s and family’s beliefs. Conflicts can arise between beliefs and care, however, so it’s best to make sure your Advanced Directive, and the people you designate as having power of attorney, are clearly aligned with your beliefs.
 

An Advanced Directive can’t cover everything, yet most have a place for additional statements of desires regarding healthcare.
 

Where do I keep my Advanced Directive?

Nevada provides an Advance Directive Registry . You can visit to find out more about how to file your advance directive. You should also keep a physical copy at home or with whatever medical files you maintain. Give a copy to the person you have appointed as your healthcare power of attorney.

Is an Advanced Directive the same as a will?

No, the Advanced Directive is for healthcare decisions at the end of life only. It has nothing to do with trusts or wills. 

We understand that discussing these types of questions can feel awkward and uncomfortable. No one likes to think they may become incapacitated one day. However, taking the time now to think about your options for end-of-life care and making them known will bring peace of mind to you and your loved ones no matter what happens in the future. 

If you have questions about Advanced Directives, call us at 702-380-8300.