Frequently Asked Questions

Grief Support Group - English

May 6, 2008
1:30 pm

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Hospice Hop Fundraiser

June 13, 2008
6:30 pm

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Please click here to register for the 13th Annual Palliative Care Symposium.

Hospice El Paso, Inc.
2525 E. Missouri
El Paso, TX 79903

Phone: 915-532-5699
Fax: 915-532-7822

Who Owns and Operates Hospice El Paso?

Hospice El Paso, Inc. is a community based non-profit organization. Its tax exemption was granted in 1981 under Section 501C(3) of the Internal Revenue Code.

The Hospice Board of Directors is composed of 25 community leaders and medical professionals who are concerned about the needs of persons residing in El Paso County who are terminally ill. The Board is actively involved in support of the organization and in fund raising activities.

Hospice is supervised by an Executive Director who is responsible for the day-to-day operation of the organization; a Medical Director who provides guidance and direction in the medical component of the patient care program; a Director of Patient Services who oversees the clinical service areas; a Business Manager, a Director of Volunteers and a professional education team.

Is Hospice Licensed and Certified?

Hospice El Paso is licensed by the State of Texas and is certified by Medicare and Medicaid to provide the Hospice Benefit. It is accredited by the Joint Commission on Accredidation of Healthcare Organizations.

What is Palliative Care?

The goal of palliative care is to ensure that the patient is as free from pain and other symptoms as possible. The patient's medical needs are cared for by professional nursing personnel and hospice care attendants under the direction of the patient's personal physician. Social and psychological needs are attended to by social work professionals, while volunteers supplement these activities with families. Spiritual needs are addressed when requested by the patients. These are dealt with through the minister of choice, or by the Hospice Chaplain. Working as a team, these professionals, along with the patient's primary caregiver, work to assure that the patient receives the proper care and achieves the best possible quality of life.

What are The Admissions Criteria?

Admission is available to persons with a terminal illness whose life expectancy is six (6) months or less as certified by the patient's attending physician and the Hospice medical director.

Most patients have an established patient/physician relationship. Every effort is made to maintain this relationship for as long as the patient’s life continues. Care must be palliative in nature, and a cure through normal treatment can no longer be expected. The primary focus of care will be supportive and symptomatic. Specific complications or intervening illness will be dealt with in a manner appropriate to the patient.

Physicians licensed in the State of Texas, or eligible to practice in an El Paso governmental facility may admit patients to the program. The primary physician gives consent to the patient's admission and provides ongoing medical direction in cooperation with the Hospice team.

The patient and family must be informed of the diagnosis and prognosis, understand the Hospice philosophy, be willing to cooperate and participate in the Hospice program, and plan to care for the patient at home for as long as possible.

The patient must reside in El Paso County, Texas.

Admission to care will not be denied on the basis of national origin, race, creed, sex, religion, age, physical or mental handicap. Hospice provides services for patients without a third-party payment source within available resources.

Because the patient will decline and will need support as the disease progresses, a primary caregiver who is willing and capable of assuming responsibility for the patient or foster care should be designated. If the patient is able to care for him/her self, is able to self-administer medications and function independently in activities of daily living, he/she may be admitted into the program with the understanding that that he/she will obtain a caregiver when he/she can no longer live independently. A willing, responsible party who will provide a caregiver if the patient becomes incapable of making his own decisions is helpful in facilitating care. The patient and responsible party maintain the right to revoke the Hospice election at any time.

The Hospice team, working with the patient and the family is responsible for determining the appropriate location and level of care after consultation with the attending physician, medical director, and family.

A series of diagnostic criteria have been developed to use as guides by the attending physician in making the decision to recommend hospice care. These may be reviewed upon request to the Hospice Executive Director at (915) 532-5699.

When Should a Decision About Entering a Hospice Program be Made?

At any time during a life-limiting illness, it is appropriate for a patient or family to discuss all of the issues related to care. Understandably, many patients and family members are uncomfortable with the idea of stopping an all-out effort to beat the disease. Hospice staff members are sensitive to these concerns and are available to discuss them with the patient and family. Prior to admission, a plan of care is developed based upon the wishes of the patient.

When the patient and family in cooperation with the attending physician determine that curative care is no long the best course of treatment, the patient should be referred for hospice care.

Should I Wait for Our Physician to Raise the Possibility of Hospice Care or Should I Ask First?

The patient and family should feel free to discuss Hospice care at any time with their physician, other health care professionals, clergy or friends. Patients have the right and responsibility to be fully informed about their disease, prognosis and care options.

What if Physicians Don't Know About the Hospice?

Most physicians know about Hospice. If your physician wants more information about Hospice, it is available from the Academy of Hospice Physicians (352-377-8900); the National Hospice Help line (1-800-658-8898); or Hospice El Paso (915-532-5699).

Can a Hospice Patient who Shows Signs of Recovery be Returned to Regular Treatment?

Absolutely. If the patient's condition improves or stabilizes or the disease seems to be in remission, a patient may be discharged from Hospice and, if they choose, return to curative therapy. If the person should later need hospice care, coverage may resume.

Is There any Special Equipment that I Must Purchase or Changes that I Have to Make to my Home Before Hospice Care Begins?

A Hospice nurse and/or medical equipment professional will visit the home, assess the patient's needs and make arrangements to obtain necessary medical equipment. Often the need for equipment is minimal at the start of care, increasing as the disease progresses. If equipment is needed, a Hospice team member will visit the home and discuss the need with the patient and family. It is the goal of Hospice to help the patient and family have a comfortable and safe home environment. Modifications are rarely necessary.

What are the Requirements for In-home Caregiver Assistance?

At the time a patient enters the Hospice program, many are ambulatory and independent. As the disease progresses and the patient becomes less able to care for themselves, the need for caregiver assistance increases in importance. Often the caregiver is the patient's spouse, an adult child or children, friends, expanded family, or a paid caregiver for a specified number of hours per day. As the disease process continues, Hospice nurses assess the patient's condition and work with the patient and family to determine the level of care required.

How Many Caregivers are Needed?

There is no set number of caregivers needed. At the start of care, the Hospice team prepares an individualized care plan that addresses the short and long term care giving requirements for the patient. Hospice nurses, social workers and home health aides visit the patient regularly. They are accessible 24 hours a day to answer medical and psychological questions and concerns, as well as to 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 at all times. As the disease progresses, one of the most common fears for patients is that of dying alone. When the patient becomes non-ambulatory or has medical complications, Hospice recommends that someone be with the patient. To assist the caregiver, volunteers, friends and others provide respite care. Respite can also be provided when appropriate.

How Difficult is Caring for a Dying Loved One at Home?

The process of dying is different for every person. Some patients die in a few hours or days. Others have a quality end-of-life process that lasts several months. The Hospice staff teaches caregivers the "how to's" of care and are available to assist the patient and family 24 hours a day. When help is needed, a social worker or nurse is available to help meet patients needs.

Does Hospice do Anything to Make a Death Come Sooner?

Hospice does nothing to hasten or retard the end of life process. Just as doctors and midwives lend support and expertise during the time of childbirth, Hospice staff provides support, guidance and specialized knowledge as life nears culmination.

Is Caring for the Patients at Home the Only Place Hospice care can be Delivered?

No, although 90% of a Hospice patient's time is spent in a personal residence, some patients live in a nursing facility, foster home, or the home of a family member or friend.

How Does Hospice Manage Pain?

Hospice believes that the etiology of pain is emotional and spiritual, as well as physical. Our staff and physicians use the latest medications and technique for pain and symptom management while encouraging the patients to be mobile, self-sufficient, and function independently for as long as possible. Pain is treated aggressively to assure the best quality of life possible.

What is Hospice's Success Rate in Managing Pain?

Using a combination of medications, counseling and personal care, most patients are able to achieve a level of pain that is comfortable for them.

Will Medications Prevent the Patient from Being Able to Function Independently?

It is a goal of Hospice for the patient to be alert, as free of pain and other symptoms as possible and able to function independently. Success for the patient is usually achieved through coordination of physician, nursing and patient efforts.

Is Hospice Affiliated with any Religious Organization?

Hospice El Paso, Inc., is not affiliated with any religious organization. While churches and religions in various parts of the United States have started hospices in connection with hospitals, these hospices serve the entire community and do not require patients to adhere to any particular belief, religious creed, or to receive the services of a chaplain. If a patient desires a chaplain or minister of a particular faith, Hospice works to help the patient and caregiver/family receive the desired spiritual support.

How Is Hospice Reimbursed?

Coverage is available through Medicare and Medicaid (in Texas). Many private health insurance policies also cover hospice care. To be certain of coverage, families should ask their employer or health insurance provider. Although covered, under some circumstances benefits are limited. Coinsurance and deductibles are the patient or family responsibility.

Patients who request consideration for financial assistance are evaluated and financial arrangements are made based on their ability to pay. Services provided to patients who are unable to pay are underwritten by memorials, donations, grants and the Celebrity Waiters Luncheon.

If the Patient is Eligible for Medicare, Will there be any Additional Expenses to be Paid?

Medicare and Medicaid cover all services and supplies for the hospice patient. Coverage under private insurance varies. Most private and group insurance has a coinsurance and deductible. Please ask your employer or health insurance provider.

If the Patient is not Covered by Medicare, Medicaid, or any Third-Party Health Insurance, will Hospice Still Provide Care?

Hospice provides care to patients without regard to their ability to pay, within available resources. At admission, a financial assessment is performed for patients and families who do not have a third party source of reimbursement. Funding for such patients may be provided by foundations, community donations, memorials or through fund raising events such as the Celebrity Waiters Luncheon. Hospice will make every effort to assist the patient and family to obtain coverage through one of the grant programs available to Hospice. If no source of funding can be found, fees based upon a sliding fee scale will be determined. For patients who have no financial resources, care may be provided through the community assistance program.

Does Hospice Provide any Help to the Family After the Patient's Death?

Hospice provides continuing contact and support for the family, caregiver or partner for up to 13 months following the death of a loved one. Hospice also sponsors bereavement groups and support activities for members of the community at large who have experienced a recent loss.

What Services are Routinely Provided?

At the start of care, a nurse and social worker do an initial assessment of the patient. A determination is made of the physical needs of the patient, equipment, medicines, supplies, supportive services, requirements; the support needs of the caregiver and other family; financial and legal need; and spiritual and counseling needs.

From this assessment, the Team Plan of Care is developed with the patient and family, with concurrence and recommendations of the patient's primary physician as well as Hospice's Medical Director. Professional nursing visits are scheduled based on the patient's physical condition. The frequency is adjusted as necessary. Visits are scheduled to monitor the patient's condition, determine efficacy of treatment/medications, do wound care, instruct the family or caregiver in patient care techniques, and provide anticipatory grief guidance for caregivers and other family members.

A professional nurse supervises the care provided by Hospice care attendants. These personnel provide physical care which can include personal hygiene, nutritional and elimination support, as well as maintaining the patient's environment in a safe manner.

Social workers elicit the patient's and the family's views of illness and of the family system. They work within this framework to:

Enable the family to solve resource deficits
Provide communication tools for the solution of perceived patient and family problems and dealing with accumulating losses
Help the patient and the family begin to incorporate changes in condition and roles in preparation for an appropriate death.

Bereavement services are provided to the family for up to 13 months after the loss of a loved one.

When is Care Available?

Care is available 24 hours per day, 7 days per week. Office hours are from 8:00 a.m. to 5:00 p.m. After hours services are available through an on-call nurse or social worker who responds personally to all calls for assistance. Home visits will be made when appropriate.