How to Find the Best Florida Hospice Provider for Your Loved One
Do you or a loved one need hospice care in Florida?
There are lots of resources related to both seniors and those who are ill. A lot of the resources related to those communities I can't directly help them with because I just do legal work. And That’s why I connect with experts from different fields related to those who serve the elder, the senior, the ill, and the disabled communities, so they can talk about their specific area of expertise.
With that in mind, Susan Robertson is the regional manager of business development for ProMedica, a hospice provider in Miami-Dade and Broward County. Some people may be more familiar with the name “Heartland Hospice,” which is what ProMedica Hospice was known as until three years ago. They’re still serving the same communities of Broward and Dade counties, as people have come to expect.
Susan gave Elder Needs Law some insight into what hospice is, what patients and families can expect, and how to find the best Florida hospice provider for your needs.
What is Hospice?
Hospice is a benefit that is probably one of the most underutilized services for people in need and who are eligible for any healthcare component or line of service. That’s why a primary focus at ProMedica Hospice is to be at the forefront in the community – to be visible to people. That may be direct consumers or people who work with other consumers to help educate about what hospice is, what it entails, and what can it do for you.
Hospice addresses that thing that is going to happen to all of us at some point in time in our lives, whether we want to face it or not. Sometimes it happens sooner than people want and sometimes it's later, but it's a natural thing.
Who is Eligible for the Hospice Benefit?
Medicare oversees the hospice benefit and Medicare defines eligibility for hospice simply as someone who has a chronic illness or disease and two physicians will certify that, if it is to run its natural course, within six months or less, there’s a good chance that the person will likely not be living any longer. That's the basic definition of hospice eligibility.
Now, having said that, does that mean that anybody who comes on hospice is going to die within six months from the day they come on hospice? A lot of people have a fear that if they put their loved one on hospice, or if they go on hospice themselves, the end of life will come sooner than it would if they did not go on hospice.
What’s interesting is that people who actually sign up for and elect the hospice benefit tend to live longer than if they did not sign up for hospice.
What Does Hospice Entail?
Many people think that if they or their family member goes on hospice that they have to give up a lot of care services. This is not the case. Hospice entails many different things. It really depends on what the individual is looking for and what they want to have for their end-of-life care from the hospice partner.
At its basic level, hospice is access to direct care from medical professionals.
A registered nurse (RN) is the case manager for the care of the person on hospice. There are also certified nursing assistants (CNAs), who will come to where the patient is and assist the caregiver and help with that patient.
The hospice benefit also includes social services – a social worker. Community resources are at the fingertips of the social worker, and they can help the patient, the family and caregivers with other additional resources that can be helpful for them in living a quality end of life.
People going through hospice themselves or have a family member on hospice are not only going through a physical crisis, but also an emotional one or even a spiritual one. That’s why another component that hospice has is bereavement. It’s the job of the bereavement coordinator or specialist to help at all points of time: From before the patient comes on the hospice benefit, through their being on the benefit, and then after the patient passes away.
There are so many things that are going through not only the minds of the caregivers but the emotional drain and strain on the patient as well as the potential guilt of the loss of a loved one. As we all experience that first year after somebody dies, every major holiday, birthday, anniversary, something that was special or had a sentimental attachment becomes enhanced in terms of grief.
This is a big component of hospice and people don't realize that it's there for them. They can get caught up in the hole. Most of us don’t want to think about death and dying. We think if we don't face it, we won’t have to go there, right? But it's there. And it's real.
The bereavement component of hospice gives people the ability to steer towards support and counseling and hear some other people who've experienced the same kinds of things that they are experiencing
Hospice Isn’t Just for the Patient, but for the Family
Most healthcare services are geared only to the patient themselves, right? We go to the doctor and they only talk to us the patient. We go to the hospital and the patient is the one who's being treated. In post-acute rehab and even patient home health, it's the patient who's being taken care of.
Hospice is the one benefit where you have as much care and service delivery for the family and the caregivers as you do the patients themselves. And that's important. That's what helps us all rally together to do what is best for the patient but to help meet their needs and their wishes.
How Much Does Hospice Cost?
The great thing about the hospice benefit is people have already paid for it, so you get the benefit for no additional cost. Everything that is a part of the hospice care is covered under the Medicare benefit.
This is also true for people who have signed up for the Medicare Advantage plans in lieu of the traditional Medicare because they are a Medicare eligible recipient. So, if you’ve have signed up for Humana gold or any of the other numerous Medicare Advantage plans, it does not exclude them from the hospice benefit.
If, for some reason, you don't have Medicare but you have Medicaid, Medicaid will pay for hospice as well, which is really important. People ought to know that this is a completely free service and to not take advantage of it is a waste. That's what your tax dollars go towards.
Advanced Care Planning and Hospice
In Florida, hospice is granted through a certificate of need. What that means is that the county offers up a certificate of need for the patient, and then hospices can apply for it and get awarded. This means that you could have multiple different hospices across the state, county by county, applying for the certificate and not any of them will be remotely the same.
This lends itself to an exercise, if you will, for family members, caregivers, and patients themselves to really sit down and discuss advanced care planning.
We should all be talking to our loved ones about end-of-life care. This is the one time we get to have a say in what we want to have happen to us if we're not able to say it ourselves. That way, those who are going to be in charge of us if we can't be ourselves, can communicate what we want to the hospice provider. They won’t be afraid to say, ‘this is what my loved one wants to have happen and what they do not want to have happen.’
Questions to Ask a Hospice Provider
If the hospice just automatically says that they’ll do anything you want, that's probably not the right answer. There are a lot of questions and stipulations that should be coming from that hospice provider.
Do you want to go to the hospital? What does that mean for you? Are they going to abide by that as a hospice provider?
Do you want to have a do not resuscitate order? Maybe the hospice provider is saying you must have a do not resuscitate order to get on that particular hospice? Medicare doesn't make you do it to get the hospice benefit, but some hospices require that right.
What are the extensive types of, of comforting treatments that the hospice will provide? Not all hospices treat all treatments as comforting versus curative? Wound care is a good example of that. If there's something going on with the skin and care is needed, is the hospice going to provide that care?
Will they provide additional or supportive means of nutrition and different kinds of things like that?
People should ask those questions because that's going to help determine whether this the right hospice for the patient.
The bottom line is, hospice is not is not hospice is not hospice. They all have the same rules to follow, but each hospice, as an entity, can choose what they want to provide and what they don't want to provide that's outside of the scope – and they're not required to provide everything.
The more questions the family or the consumer asks, that will help them determine what's going to meet their needs.
About ProMedica Hospice
Very simply, everyone's end-of-life care looks different. What they think it looks like, what they want it to look like, how they want it to be, and where they want to be is their decision, and theirs alone. The hospice benefit and care delivery should be reflective of that.
At ProMedica, everyone has their own very individualized tailored care plan. As it changes, ProMedica changes with them because, ultimately, it's a privilege to be there with them for this very, very difficult time. Anybody who has hospice should be able to have hospice the way they want to have their end-of-life care journey and they understand that at ProMedica.
Contact an Elder Needs Attorney
If you’re unsure about how you or a loved one will be able to pay for long-term or end-of-life care, an experienced elder needs lawyer can help walk you through the process. Elder Needs Law serves people throughout Florida with asset protection, Medicaid and Medicare planning, and other estate planning needs. Reach out for a consultation today.