It is only natural to have questions at a time when you are considering
support for a serious illness or care at the end of life. A list of some
of our most common questions is provided for your reference below.
At Unity, we welcome your questions.
Our staff is here to respond to all of your concerns. To speak to a member
of our staff, call
920.338.1111 or 800.990.9249.
Hospice and Palliative Care
Q: Is hospice a place?
Hospice is a specialized form of health care and is not a place. Hospice
care provides a special team approach to support the physical, emotional and
spiritual needs of people who are in the last six months of life and are no
longer receiving curative treatment.
Hospice care can be provided wherever a patient resides, whether in a private
home, nursing home, community-based residential facility (CBRF), residential
care apartment complex (RCAC) or the Jack and Engrid Meng Residence (Unity's
home-like hospice residence that features 12 private rooms).
Q: Is there a distinction between hospice and
palliative care?
Yes. Hospice and palliative care both are specialties that provide comfort
care, relief of suffering and improved quality of life; however, hospice care is
available to individuals with a life expectancy of six months or less who are
not seeking curative treatment, while palliative care is offered to all
individuals during the course of an illness, regardless of whether or not they
are seeking curative treatment.
Q: Is hospice the same as home health nursing?
No. Home health nursing is designed for short-term, rehabilitative
interventions for home-bound individuals with a skilled medical need; whereas,
hospice care addresses continuity of care during the last six months of a
patient's life and does not require the patient to be home-bound. Hospice
care also provides an interdisciplinary team including a nurse, social worker,
certified nursing assistant, chaplain, volunteers, grief counselor and medical
director.
Q: When should patients and families consider hospice
or palliative care?
After an individual is diagnosed with a life-limiting illness, the patient and
family should evaluate whether or not hospice or palliative care is appropriate.
Unity's staff would be happy to meet with you and explain care choices available
to support your needs.
Q: What does the admission process involve?
Upon placing a call to Unity, a referral nurse will speak with you. You
will be asked various questions, such as the name and contact information of the
prospective patient, prognosis, physician name, etc., to aid in gathering
information for further discussion. A social worker and/or nurse from
Unity will then schedule a meeting with the prospective patient and family to
discuss care needs and how Unity can help. Our goal is to make this
contact within 12 to 24 hours of receiving the referral. Throughout the
admission process, Unity staff is happy to answer your questions and guide any
necessary paperwork. Individuals are at no time obligated to sign onto a
Unity program, and strict confidentiality is honored at all times.
Q: Does hospice do anything to hasten death?
Hospice care neither advances nor suspends the dying process. Rather,
hospice care focuses on patient comfort and offers specialized knowledge at the
end of life.
Q: How is hospice different from other medical care?
Hospice care takes a holistic approach, providing physical, emotional and
spiritual care to the patient and family with an interdisciplinary team
approach. Care teams include physicians, nurses, social workers,
chaplains, grief counselors and volunteers. The main focus of care is to
control the patient's pain and symptoms and provide comfort.
Q: How is Unity different from other area care
providers?
Unity has been providing end-of-life care to the families of Northeast Wisconsin
for over 30 years, longer than any other hospice-care organization in Northeast
Wisconsin. In 2002, Unity began offering palliative care to the community.
As the only locally-owned hospice organization offering a free-standing
palliative care program, Unity provides holistic physical, emotional and
spiritual care to all patients diagnosed with a life-limiting illness. The
largest not-for-profit hospice and palliative care organization in Northeast
Wisconsin, Unity is a partnership of its three founders: Bellin Health, St.
Mary's Hospital Medical Center and St. Vincent Hospital.
Q: How do patients and families rate the care Unity
provides compared to that of other providers?
As described in its mission, Unity's goal is to provide dignity, comfort and
self-determination to all individuals coping with a life-limiting illness or the
issues of grief and loss. Unity participates in a nationwide family
evaluation survey created by the National Hospice and Palliative Care
Organization (NHPCO) and has implemented additional survey tools to aid in
measuring our services.
Historically, caregivers responding to the surveys have rated Unity at or above
the state and/or national averages for areas such as treating patients with
respect, coordination of care and emotional support of family during care and
after the loss of a loved one. As a result, virtually every family who has
responded to the surveys has stated they would recommend Unity's services to
others.
Unity will continue to listen to both the needs of our patients and their
families. We consider this a priority as well as the right thing to do.
Place of
Residence
Q: Do patients have to leave their homes to receive
hospice or palliative care?
No. Most patients, as long as they are able, choose to stay in their homes
to receive hospice or palliative care. Hospice care can be provided to
patients regardless of their residence. This includes private homes,
nursing homes, community-based residential facilities (CBRFs), residential care
apartment complexes (RCACs) or the Jack and Engrid Meng Residence (Unity's
hospice residence). Palliative patients may receive care in their private
homes, CBRFs or RCACs. Both hospice and palliative care continue to
support patients who may need hospitalization while on the program.
Q: What would be the reasons for using both hospice and
nursing home care?
Hospice care is not meant to replace nursing home or assisted living facility
care. Hospice care is an approach to medical care that can be provided in
any facility, including nursing homes and assisted living facilities.
Unity staff works with the staff of nursing homes and assisted living
facilities, discussing and adjusting the patient's plan of care to ensure
continuity and effectiveness of care. Typically, when hospice care is
provided in combination with nursing home or assisted living care, the facility
would provide custodial care, while Unity's programs cover all the same care
services that would be provided in a patient's private home.
Physician
Q: What if our physician doesn't know about Unity?
If your physician would like more information, we would be happy to supply
additional literature or meet with him/her as needed. Please contact Unity
at 920.338.1111 or
800.990.9249.
Q: Should patients wait for their physicians to raise
the possibility of hospice or palliative care, or should they raise it first?
Although physicians and other health care professionals refer many patients to
our programs, we also receive referrals from the patients themselves, family
members, friends and clergy. A simple phone call to the Unity office at
920.338.1111 or 800.990.9249
can answer your questions and begin the process.
Q: Can patients keep their personal physicians while
under Unity's care?
Yes. Unity's special team approach to hospice and palliative care involves
individuals who support the physical, emotional and spiritual care of our
patients. The patient's attending physician is welcome to serve as part of
this team.
Patient
Condition
Q: I've heard that hospice care is only for cancer
patients. Is that true?
Hospice care is for all people who have been diagnosed with a life-limiting
illness with a prognosis of six months or less and who are no longer receiving
curative treatment. Unity's team has experience caring for people of all
ages with a variety of diagnoses including, but not limited to: cancer, heart
disease, debility, dementia, Alzheimer's disease, lung disease, stroke or coma,
kidney disease, motor neuron diseases, liver disease, and HIV/AIDS.
Q: Doesn't signing onto hospice mean my loved one is
giving up?
Choosing to use hospice care means acknowledging that terminal diseases in their
advanced stages most often cannot be cured. The holistic approach to care
in hospice–physical, emotional and spiritual care–means providing patients with
comfort and dignity as they approach the end of their lives. We seek to
provide comfort care by controlling symptoms, which allows individuals to make
the most of each day.
Q: What are the different levels of hospice care?
1. Routine home care is provided to all patients within their
place of residence for as long as they continue to meet their hospice admission
criteria.
2. General inpatient care is provided at an inpatient facility
or hospital for patients who require skilled nursing care due to an acute
exacerbation of symptoms.
3. Respite care is a temporary transfer of a patient from home
to a nursing home, or, in special circumstances a hospital, for three to five
days to provide caregivers a break from their duties.
4. Continuous care is provided at the patient's residence
during a short-term, temporary period of crisis.
Q: What if a patient chooses hospice care and then
lives more than six months?
In determining eligibility for hospice-care benefits, a physician must declare a
patient's prognosis to be six months or less, if the disease or condition would
run its regular course. There is no way for a physician to know someone's
exact life expectancy. Hospice care will typically continue with coverage
through Medicare and other insurance providers if the disease continues to show
a limited life expectancy.
Q: What if the patient's condition improves?
Patients under hospice care will sometimes see signs of improvement in their
health. Hospice care is a choice. As such, patients can choose to
leave the hospice program and even seek treatment, if desired. In this
case, palliative care may be an appropriate choice for the patient to continue
to receive in-home care. If the patient's condition again worsens, making
them eligible for hospice care, they can re-elect the hospice benefit.
Medication and
Equipment
Q: Is there any special equipment or are there changes
needed in a patient's home before care begins?
Hospice and palliative cares are philosophies of care. They do not
necessarily require any changes to a patient's living arrangements. Unity
staff will work with the patient and family to guide them in recommended
changes, equipment needs, etc., and will coordinate obtaining what is necessary.
Q: Will a patient's medication be continued once they
begin receiving hospice services?
A patient's medication continues to be administered during hospice services.
If and when the medical condition necessitates a change in medication or a
medication type (i.e. pills, liquids, etc.), the Unity team will consult with
the patient, family and physician.
Q: Will medications prevent the patient from being able
to talk or know what is happening?
No. Unity works with the patient to adjust medications to keep the patient
comfortable.
Q: Does a patient need to agree to a DNR order to be
admitted to the hospice program?
Unity does not require a patient to agree to a DNR (do-not-resuscitate) order.
Patients and their families/caregivers are counseled and educated, upon
admission and as needed, regarding the hospice philosophy, and are given
information regarding Advance Directives. A patient's Advance Directives
and resuscitation status are documented in the medical record.
Caregiving
Q: How many family members or friends does it take to
care for a patient at home?
The number of caregivers needed differs depending on the patient's individual
needs. Upon signing onto the hospice or palliative program, Unity staff
will develop a plan of care for the patient, outlining the caregiver needs.
While Unity staff will make regular visits to the patient, they are not with the
patient at all times. Unity staff will teach caregivers and family members
how to care for the patient on a routine basis, help patients locate appropriate
in-home services, if desired, and help supplement caregiving needs with trained
volunteers, where necessary.
Bereavement
Q: What types of emotional and spiritual support does
Unity provide?
Through a holistic approach to care, Unity cares not only for the physical
symptoms, but the emotional and spiritual needs of our patients as well.
Unity's interdisciplinary care team includes social workers, grief counselors
and chaplains in addition to skilled nursing staff. Support programs are
offered to the family both while serving as caregivers and after death.
The Unity chaplains are able to help address spiritual concerns and needs, and
can work in conjunction with a patient's faith leader, if desired.
Q: Does Unity provide any help to the family after the
patient has died?
Yes. Unity team members offer caregivers bereavement care for minimally
thirteen months following the death of a loved one. A bereavement plan of
care is arranged with the team and the family and may include mailings,
newsletters, invitations to support groups and individual grief counseling.
Bereavement services are offered to all members of the community, regardless of
their affiliation with Unity.
Q: Is it possible for a family member to receive
bereavement counseling through Unity even if the patient did not receive Unity's
services?
Yes. Unity's bereavement programs are available for any member of the
community who has experienced the death of a loved one, whether or not the loved
one used Unity's hospice or palliative care services. The bereavement
programs are designed to support grieving people by helping adults, teens and
children understand that grief is a natural and normal response to loss.
Payment/Insurance
Q: How is payment handled?
Unity bills Medicare, Medicaid and insurance when it is available for hospice
and palliative care and will accept patients regardless of their reimbursement
source and ability to pay. Many of our patients are not encumbered with a
bill due to our community care policy, recognizing people in need. Unity's
staff is happy to coordinate and explain the payment process.
Q: If the patient is not covered by Medicare or any
other health insurance, will Unity still provide care?
Unity accepts all patients regardless of their insurance status or income.
Unity is fortunate to receive financial support from community donations for
patients with limited or no insurance coverage, which helps us maintain our
mission of ensuring that all individuals have access to support and quality
holistic care.
