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What Are the Advantages and Disadvantages of Hospice Care?

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Updated April 17, 2014

Question: What Are the Advantages and Disadvantages of Hospice Care?
Hospice care is a philosophy of care that embraces the idea of comfort and dignity at the end of life. Hospice care addresses the physical, practical, emotional, social and spiritual needs of the patient and their family and caregivers.

Toward this end, there are advantages and disadvantages of choosing hospice care.

Answer:

Advantages of Hospice

The advantages of hospice include comprehensive, interdisciplinary care from a team of professionals and volunteers. This care involves physicians, nurses, home health aids, social workers, chaplains and trained hospice volunteers to meet the needs of the patient and their caregivers.

Care is available 24 hours a day, including weekends and holidays. Patients and their caregivers always have access to hospice professionals when they need it.

Choosing hospice usually means a reduction in out-of-pocket expenses for medications, durable medical equipment, and medical supplies. Medicare, Medicaid, and private insurances cover the cost of these necessary items for hospice patients.

When a patient is truly ready for comfort care, choosing hospice care means avoiding unwanted hospitalizations and medical treatments and procedures. The hospice team aims to support the patients and caregivers wishes while helping them achieve their goals for care.

Disadvantages of Hospice

The significant disadvantage of choosing hospice care is the restrictions placed on the various aspects of treatment. Under the Medicare Hospice Benefit, hospice is paid a flat per diem rate for which all medical expenses must be paid by. This results in several difficulties:

  • Diagnostic tests such as blood work and x-rays, although warranted by the patient's attending physician, fall to the financial responsibility of the hospice agency. Because these tests are expensive and may not always be beneficial, hospice agencies often don't approve them.
  • Hospitalizations are discouraged once a patient is under hospice care. The hospice benefit does have provisions for short-term hospital stays, called inpatient care, for symptom management, but the criteria for admission and coverage for specific treatments is poorly defined.
  • Participation in experimental treatments or clinical trials aren't allowed as they are considered life-prolonging. Also, some treatments or procedures that are considered life-prolonging, such as feeding tubes, may not be covered.

Unfortunately, the disadvantages outweigh the advantages for some patients, resulting in underutilization of hospice services and short lengths of stays. Many patients aren't referred to hospice until they are very close to death, missing out on much of what hospice has to offer. Misconceptions about hospice and lack of awareness of benefits and services also contribute to the underutilization.

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  5. Hospice Care - Advantages and Disadvantages of Hospice Care

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