Change the Text Size

Hospice is a program of compassionate, family-centered care that allows terminally ill patients to remain at home, in control of their lives and surrounded by loved ones. A team of hospice professionals provides not only expert pain and symptom management, but also emotional and spiritual support, which extends to bereavement care for families after a patient has died. Hospice focuses on quality of life rather than length of life; to that end, hospice neither hastens death nor prolongs life. The hospice team includes a medical director, nurses, social workers, home health aides, chaplains, a music clinician, bereavement counselors, and trained volunteers.

How do I get hospice care?

You may call hospice directly at any time, or speak directly to your physician. A referral to hospice may be made whenever a patient and family are faced with a terminal illness. The patient can be referred to hospice by family members, friends, clergy, or health professionals, but the referral must be accompanied by an order from the patient's physician. Hospice of Missoula will evaluate the patient to determine eligibility, and will coordinate individualized care with the family and primary physician.

When is the time for hospice?

Anyone with a terminal illness and a life expectancy of six months or less can benefit from hospice care. Generally speaking, sooner is better than later. With hospice support, patients usually experience a positive change in their quality of life. Hospice provides the opportunity for patients to live as well as they can for as long as they can.

What is the role of my physician?

The Hospice of Missoula team works under the supervision of the patient's family physician. Our medical director is Dr. Eric Kress, a family practitioner trained in pain management and end-of-life care. Dr. Kress consults with the patient's primary physician and visits patients whenever possible, to care for the patient's medical needs. All orders for medication are written by the patient's primary physician.

Should I wait for our physician to raise the possibility of hospice?

No, because not all physicians are familiar with the details or benefits of hospice care. The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy, or friends. Patients may also call hospice directly.

What if our physician doesn't know about hospice?

Most physicians know about hospice, but if they don't it is okay to ask them to look into it. If your physician wants more information, it is available from Hospice of Missoula, the American Academy of Hospice and Palliative Medicine, or the National Hospice and Palliative Care Organization (800-658-8898). In addition, information about hospice is available from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration. See also our helpful links pages for more resources on hospice to go over with your physician.

Can a hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If improvement in condition occurs and the disease seems to be in remission, the patient will be discharged from hospice care. Patients may also revoke the Medicare Hospice Benefit at any time, for any reason. If a patient is discharged or revokes the Hospice Benefit, the patient may be readmitted at a later date with a physician's order.

Does hospice do anything to hasten death?

Hospice neither hastens nor prolongs the dying process. When a patient or family has decided to let nature run its course, hospice supports that goal by providing comfort care. At this time, hospice care in Montana does not include Physician Aide in Dying (PAD). For more information about PAD visit http://compassionandchoices.org.

Is a home the only place hospice care is provided?

No. Hospice care is provided anywhere the patient resides, including private residence, nursing homes, assisted-living facilities, and hospitals.

How does hospice "manage pain"?

Hospice nurses and doctors are trained in the latest medications and technology for pain and symptom management. In addition, physical and occupational therapists may assist patients in remaining as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, diet counseling, and other therapies. Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these as well. Counselors, including clergy, are available to assist family members as well as patients.

What is hospice's success rate in battling pain?

Very high. Using a combination of medications, counseling, and therapies, most patients can attain an acceptable level of comfort. Will medications prevent the patient from being able to talk or know what's happening? Sometimes, but usually not. The goal of hospice is to help patients be simultaneously comfortable and mentally alert. By constantly consulting with the patient and the physician, hospice is often successful in reaching this goal.

Is hospice affiliated with any religious organization?

While some hospices are affiliated with religious organizations, Hospice of Missoula is not. We provide care to patients regardless of their religious or spiritual beliefs.

Is hospice covered by insurance?

Hospice is covered by Medicare nationwide, by Medicaid in some 42 states, and by most private insurance policies. To be sure of coverage, families should check with their employer or health insurance provider. Hospice of Missoula provides hospice care regardless of an individual's ability to pay, through charitable donations to the Foundation for Hospice of Missoula.

What does hospice cover?

In general, hospice covers services related to the terminal illness, including a physician, nursing and other hospice team members, medical equipment, supplies and medication for pain and symptom management. It also includes short-term inpatient and respite care.

If the patient has no insurance will Hospice of Missoula still provide care?

First, Hospice of Missoula will assist families in finding out whether patients are eligible for any coverage they may not be aware of. Hospice of Missoula provides hospice care regardless of an individual's ability to pay, through charitable donations to the Foundation for Hospice of Missoula.

What does the hospice admission process involve?

Hospice will contact the patient's primary physician to make sure they agree that hospice care is appropriate for the patient at the time. An appointment will then be made for a Hospice of Missoula team member to visit with the patient, family, and/or caregivers to explain in detail what hospice provides and answer any questions. If the patient and/or family feels that all curative measures have been exhausted and that comfort care is the focus, an admission to hospice will be completed. Consent forms will be signed and a plan of care will be developed according to the needs of the patient and family.

Is there any special equipment or changes I have to make in my home before hospice care begins?

Hospice of Missoula will assess your needs, recommend any necessary equipment, and make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the illness progresses. In general, hospice will assist to make home care as convenient, clean, and safe as possible.

How many family members or friends does it take to care for a patient at home?

Every patient and every situation is different, but in general we require that each patient has at least one primary caregiver. The hospice team will prepare an individualized care plan that addresses the amount of caregiving a patient needs. The hospice staff will visit regularly and a nurse is available 24 hours a day to answer questions and provide support.

Must someone be with the patient at all times?

In the early weeks of care, it is usually not necessary for someone to be with the patient all the time. Later, however, as a patient declines, hospice generally recommends constant caregiving.

How difficult is caring for a dying loved one at home?

It's never easy and sometimes can be quite hard. At the end of a long progressive illness, nights especially can be very long and lonely. However, a hospice nurse is available around the clock to consult with the family and to make night visits when necessary.

Are there initial steps I can take to make sure I get hospice care when the time comes?

Ideally, everyone would make their views about end-of-life care known to their families long before any illness strikes. Talk to your family about what your wishes are, and let them know you want hospice support when the time comes. Prepare your advanced directives. See the advanced directives page on this site for more information.

Does Hospice provide any help to the family after the patient dies?

Hospice of Missoula provides bereavement support and counseling for family and friends for at least a year following the death of a loved one. We also sponsor bereavement and support groups for anyone in the community who has experienced the death of a loved one.