Dear Carol: My dad's been in a nursing home for several years and is ready for hospice care. I read your column about hospice care being covered by most insurances, but I'm wondering what happens in a nursing home. Does insurance start to cover nursing home costs, then, too? Would it be better to move Dad home for this time period? It's hard to make these decisions at such a stressful time. - RE
Dear RE: I'm sorry that your dad is doing poorly. It's hard to see this downward spiral and know that the end of our loved one's life is in sight. You're right about the stress. I've been there and I offer my condolences.
Though I am aware that some hospice organizations are better than others, my family's experience with our local hospice couldn't have been better. I would suggest that if you have choices of hospice organizations in your community, you ask for references and follow up on them. You want the best care for your dad that is available, and you also want to feel comfortable with the care that they offer you and the rest of your family.
As far as cost, I did write a column a few weeks ago about hospice care and how it is covered by most insurance, though I also wrote that the person should check with the specific insurance that will be used. After that column ran, a hospital social worker contacted me and told me that she felt that I wasn't clear enough about the fact that while hospice care is covered by most insurance, the physical place where the care is administered is not. Nor is it possible for hospice to have someone with your loved one for extended periods. Therefore, your question is well timed.
Since your dad is already in a nursing home, you will not need to move him unless you want to. Hospice organizations work seamlessly with nursing home staff. Hospice will take over his medication and healthcare. You will, however, still need to pay the regular nursing home costs because of the bed and the staff that provides daily care for your dad.
Both of my parents were in a nursing home while receiving hospice care so I saw how beautifully hospice and nursing home care can blend. Even though hospice took over their medical care, the general care of my parents was still in the hands of their familiar nursing home caregivers which was a huge comfort for all of us. This is true whether people are private pay or on medical assistance.
For those who wish to live their last months, weeks, or days at home, hospice care would still be covered, but the family would have to provide caregivers.
Calling your hospice organizations directly can provide you with much of the information that you need about the services they can provide, but to be certain about your mom's coverage you should still check with her insurance provider.
Carol Bradley Bursack is an established columnist, blogger, and the author of a support book on caregiving. She hosts a website supporting caregivers and elders at www.mindingourelders.com. Carol can be reached at firstname.lastname@example.org.