Understanding Hospice Care: Eligibility, Cost and Purpose

How do you want to live?

It may be surprising to learn that’s the first question Emmanuel Hospice asks every new patient. Isn’t hospice about dying?

While hospice is often associated with death, Melissa Wedberg will tell you it's more about living, especially at Emmanuel Hospice, where she serves as vice president of community relations. With more than a decade in the hospice industry, Wedberg has spent years dispelling this and many other myths.

Despite having roots in the U.S. dating back to the 70s, there remains a lot of mystery about hospice. Common questions Wedberg hears include: What is hospice and who’s eligible? How does hospice work? How is hospice paid for?

The medical definition of hospice is holistic care and support for people who have been given a physician prognosis of six months or less to live, but Wedberg encourages anyone with a serious illness to learn about hospice services sooner than later. The six-month prognosis is a guideline, not a guarantee or definitive timeline.

“Individuals can be on hospice for months or even years,” Wedberg says. “Studies show hospice care can actually increase life expectancy.”

Hospice focuses on enhancing quality of life through comfort care, symptom management and emotional and spiritual support. Some providers provide those basics and so much more, as Emmanuel does with its patient wish program and complementary services such as music and massage therapy.

Wedberg stresses that anyone can inquire about hospice and be evaluated for eligibility. You don’t need a physician referral to begin the process.

“If anyone is interested in hospice care, we can do an evaluation,” she says. “A hospice physician gives the first certification, then the primary care provider can either agree or disagree that, based on our assessment, this person has a life-limiting illness that qualifies them.”

Patients must also elect to forgo curative treatments. To be clear, this decision does not involve hastening the end of life, but rather focusing on living more comfortably.

“It is important you have goals of care that align with the goals of hospice,” Wedberg clarifies. “That is to say, you no longer want to take great measures to prolong your life, that you accept your disease process for what it is and just want to be comfortable and happy in the time you have left.”

But what does that look like? Wedberg says when Emmanuel Hospice asks, “how do you want to live,” people often talk about the little things in life that matter most.

“We hear a lot about what is important to people, such as making family memories, remaining connected to their faith community, eating their favorite meals and doing activities that bring them joy,” Wedberg says. “Our team will design a care plan around the things patients want most.

“Many people also tell us they don’t want to have the trauma and the drama of medical care anymore. They don’t want to go back and forth to emergency rooms or doctor offices getting poked and prodded rather than doing what they enjoy in the safety and comfort of their home and with their loved ones.”

Another important detail most people don’t know: You have choices.

“We are really fortunate in West Michigan to have a lot of options when it comes to end-of-life care, but not every provider offers the same services or operates in the same way,” Wedberg says, encouraging people to visit Medicare.govto compare ratings. “You can call and interview multiple providers before you make a decision. It’s important to find one that’s a good fit for your needs.”

What about the cost? The good news is hospice care is often completely paid for Medicare, Medicaid and most private insurance carriers. Most commercial plans also have some form of coverage. For individuals who are uninsured, pro bono care may be an option.

“Pro bono is not the standard in our industry,” Wedberg adds. “But as a faith-based nonprofit provider, it is Emmanuel Hospice’s position that if someone needs and wants end-of-life care, the cost should not be prohibitive. Everyone deserves a good end of life.”

For more information, call 616.719.0919 or visit EmmanuelHospice.org.M