HOSPICE

HOSPICE RESOURCES 

Here are many resources for information regarding hospice services, including:

What is Hospice Care?

What is Hospice? (Hospice Foundation of America)

What is Hospice Care (American Cancer Society) 

FAQ about Hospice Care (National Institute on Aging) 

Medicare Covered Hospice Care: An Overview of the Basics (video from Medicare Rights Center) 

How is Hospice Paid For?

Hospice Care (Medicare) 

When is a Good Time for Hospice?

 Eight Signs that it’s Time for Hospice (from Amedisys Healthcare Company)

How do You Know When it’s Time for Hospice (Lake Superior Life Care and Hospice)

Tips for Finding a Good Hospice Provider

How to Choose a Hospice Provider (from the Hospice Foundation of America)

Find and Compare Hospice Providers Near You (from Medicare)

Suggested Questions to Ask Hospice Providers (from Medicare)  

HOSPICE PRESENTATION & LOCAL RESOURCES,  9/10/2025

Who were the presenters?

Housecall Providers have an outstanding reputation and have a continuum of services that includes hospice care. To date, their communication with Terwilliger Plaza has been excellent and merits our support.

Hopewell House () is the only hospice option for those needing to be in a facility.

They survive because of community support, after the Legacy system had to close it down. Financially, the ability of the original hospice programs to provide both outpatient and inhouse care, became unsustainable. The negative consequences of the burgeoning number of hospice providers , as well as the failure of patients to enroll early, made survival of residential services difficult.

Tenderly Hospice brought with them a nurse who worked here at Terwilliger and well respected. Tenderly represents one of the now rapidly growing hospice organizations that have turned to a “for profit” operation with good intentions. Hopefully, the track record of this model that swept the east coast will not follow them. 

At this Forum, we asked the providers to answer these questions.  You may want to ask these of any hospice provider you are interviewing:  

Does your company support patients that choose to utilize VSED (Voluntary Stopping of Eating/Drinking) or Medical Aid in Dying? If so, how?

 What is behind this question:

This sounds like an easy question, but examples from stories on the east coast reveal that the answer is not simple. Is there, as legal questions in the east suggest, a sinister reason for the admirable goal of hospice care to be overridden by financial needs of the institution to be financially viable ?

In the initial British model, hospice care was provided in the home 85-90% of time, with the option for in house care near the end as well as respite care for the care giver at times. 

In the USA, the ”medicare hospice benefits” struggled a bit as both physicians and patients were reluctant to stop receiving treatments such as chemotherapy and radiation therapy in order to qualify for the “Medicare hospice benefit.”

As the “for profit” hospices grew in number, there actually was a weird incentive for keeping individuals alive on hospice as long as possible. 

*In 2013, in Pottsville Pennsylvania, there was a legal case brought by a hospice nurse against a family that highlights this. See Anderson Cooper 60 minutes 2013.

How is hospice financed by individuals?

What was behind this question:

If one does not qualify or have the “Medicare hospice benefit,” can an individual pay for outpatient hospice care?

For those with Medicare, a very generous program exists. 

Requirements:

       1. qualify by having a provider document “less than 6 months to live”

       2. patient & Family agree no further chemo, radiation or hospital care

Traditional obstacles:

        1. reluctance for early commitment, so hospice only got paid for a short duration of time when most expensive /intensive help needed

        2. cost to operate any sort of “in patient” unit beyond economic feasibility

        3. dilution of economic resources with influx of “for profits” 

How does hospice support people living with dementia versus other illnesses?

       1. can someone with dementia qualify for hospice by making the decisions needed to qualify. (i.e. VSED directive)

      2. can advanced directives be written when one is competent, but still be followed when that’s no longer the case?