Frequently Asked Hospice Care Questions in Los Angeles, California

For patients that have a life-limiting illness, hospice care is the best level of care. Hospice focuses on caring, not curing, and in most cases, care is provided in the patient’s home. Hospice care can also be provided in Board & Care Homes, Nursing Facilities, Assisted Living Facilities, and other Long-Term Care Facilities. The main objective of hospice care is to provide the quality of life and dignity for a patient who has a life-limiting illness.

Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. The hospice staff members make regular visits to assess the patient and provide additional care or other services. The hospice team develops a care plan that meets each patient’s pain management and symptom control needs. Support for family caregivers is also assessed throughout the care period. While the range of services provided will vary depending on each situation and the specific needs, hospice staff are available by phone 24 hours a day, 7 days a week.

The Medicare hospice benefit covers most people receiving hospice care. This benefit covers virtually all aspects of hospice care with little or no out-of-pocket expense to the patient or family. As a result, the financial burdens usually associated with caring for a terminally ill patient are virtually non-existent. In addition, most private health plans and Medicaid in most states cover hospice services.

Medical equipment and medications needed for the patient’s care are normally covered by hospice, except those that are listed in Medicare’s guidelines for non-covered items. In cases where families opt to continue with some medications not recommended by hospice, the hospice team has discussed and assessed to determine how it will affect the overall outcome of hospice care.

The interdisciplinary team usually consists of:

• The patient’s personal physician
• Hospice physician (or medical director)
• Nurses
• Home Health Aides
• Social Workers
• Spiritual Care Providers or Other Counselors
• Bereavement Professionals
• Speech, Physical, and/or other occupational therapists

True, hospice providers usually suggest discontinuing old prescriptions. Why? Because there is an underlying question hospice providers need to emphasize. “Will the patient benefit from continually taking such medication?” However, if a certain medication may still be beneficial to the patient, we will not recommend discontinuing this. In fact, our clinicians will even help and guide you on how to properly use and/or administer the medication, in relation to current medical condition and hospice medication

One must understand that Hospice Care is focused on the comfort, wellbeing, dignity, and quality of life of the patient, as the disease takes its course without curing the disease. Therefore, Hospice Care focuses on the palliation of the disease by treating its signs and symptoms like excessive or uncontrolled bleeding; uncontrollable pain; disease related agitation or anxiety; impaired swallowing; dyspnea with increasing respiratory rate; decubitus ulcers, its prevention or worsening, etc

By discontinuing old prescriptions, it helps the human body system cope better as it begins to deteriorate and ultimately shut down. For example, excessive or uncontrolled bleeding can be caused by the patient taking potent blood thinner for the cardiovascular system. But due to the current medical condition of the patient, that medication may contribute to unnecessary discomfort, bleeding, pain, etc. The better option is to discontinue that medication and replace it with a simple aspirin if need be.

Discontinuing current medication is a complex process and it is not a standard “catch-all” approach in hospice. If you have questions on this matter, please give us a call and our trained and experienced clinicians will be glad to help you. Just call (213) 365-6499 or fax your questions to (888) 415-5250. Please leave a return phone number or email.

No, this will not speed up the dying process. In fact, there were several studies conducted by many institutions in the past regarding this practice. In 2007, a report by the National Hospice and Palliative Care Organization (NHPCO) disclosed that patients with certain terminal diseases who chose hospice lived an average of 29 days longer than similar patients who did not receive hospice. Several factors that contribute to this longer survival rate were identified by NHPCO researchers, one of which is “Over-Treatment”. Which means in hospice, over treatment is more likely avoided, which poses a huge risk in an individual’s mortality

We understand that transitioning from curative to palliative care can be very hard to accept, especially for the patient’s family or even for the patient themselves. That’s why in our organization, we have people who can help and support those who need such assistance. Please feel free to call us at (213) 365-6499. We’ll be glad to help you in whatever way we can to move forward in your ordeal

No, morphine does not hasten death if administered properly under the direction of a hospice physician and the support of the hospice team, including family members of the patient. One must understand that when people are nearing their last stage of life, some may experience extreme pain, anxiety, agitation, dyspnea (difficulty breathing), etc., and morphine can effectively alleviate all of these distressing symptoms and provide what most people would want at this stage, which is comfort and quality of life.

No, it is false. An eligible hospice patient has an unlimited number of days to stay on hospice [42 CFR 418.21 (a)(3)], provided that the patient still meets the hospice eligibility criteria set by Medicare for hospice care. Most likely, these six (6) months limitation belief evolved due to the numerous times it occurred in the entire industry itself. Considering the number of occurrences, this somehow became the standard (due to practice and occurrence) rather than compliance with existing laws

While it is true that this is happening in the hospice industry, it doesn’t mean that that is how Medicare’s hospice program works. Currently, Medicare is addressing this problem through various investigations, audits, reviews, etc. In order to find out more on this topic, please feel free to call (213) 365-6499 and ask for the Administrator or email

No. This kind of behavior is unacceptable. First, there is what we call “Patient’s Rights”. If the PCP doesn’t want to order a Hospice Evaluation order for your mom unless it is the MD’s preferred hospice agency, the MD violated Title 42 CFR Part 418.52, and the MDs behavior is an action reportable to Medicare and a Condition of Participation violation for the hospice agency the MD prefers.

One of the fundamental rights of a Patient is the right to choose which hospice agency he/she will enroll with no matter what the MD tells you. What the MD did (assuming this case scenario is accurate) could be called blackmail, coercion, intimidation etc. That’s why one good indicator in choosing a good hospice agency is to listen between the words spoken. If there is a “push” and/or “condition” before anything else??? Like in your case, run away from these people. Always remember, an MD, case manager, discharge managers, etc., can only recommend. The general rule is these people is to at least give you 3 choices (options).

To be fair on the other end of the spectrum, there are some MDs that “recommends” a hospice agency because of the trust and confidence that the agency earned while serving the MD’s patient in the past. Because of the MD’s past experiences, he would go for people he/she knows that delivers the best result for his/her patient. This is called professional “trust and confidence”.

For St. Liz Hospice, the professional relationship that we’ve developed over years of hard work is the principle that would really enhance patient care. In fact, this scenario is the best because if we fail to meet the MD’s standards of care, then there might not be a “next referral” for us.

If you’re in a situation like this, do give us a call and we’ll be glad to guide and help you through the complexities of hospice admission criteria, insurance, placements, etc.