My mother is struggling with her health and the medical prognosis is not good. I have heard such wonderful things about Hospice care but when is the appropriate time to use your services and what can I expect?

This is a very difficult time when a loved one's health is failing and we are seeking what is best for them. A person is appropriate for hospice when the physician feels if the illness continues on its current coarse life expectancy would be six months or less.

Your mom's physician would need to make this decision depending on her situation. Some physicians will contact hospice and ask hospice to evaluate the patient and make an assessment. The criteria will vary since hospice is provided to people with an assortment of diagnoses including cancer, heart disease, lung disease, Alzheimer's, kidney disease, and others.

Your mom's physician will remain her physician throughout her care if she so chooses. The hospice team will work with your mom's physician and the hospice medical director to provide her comfort care. Keep in mind, hospice is comfort care not curative care.

You should also know that Medicare, Medicaid, and private insurance can pay for hospice care.

Each hospice follows the same guidelines but each hospice is its own organization. If you want a specific hospice you must request that hospice. Hospice care focuses on helping with physical, emotional, and spiritual needs of your mom and her entire family. Hospice will have nurses and nurses' aides to assist with physical care. They will visit according to your mom's condition. If she is doing well the staff may only visit one to two times a week. If your mom's condition declines their visit frequency will increase.

Hospice also provides a social worker and chaplain to assist your mom and her family with any emotional or spiritual concerns. The social worker also is available to help coordinate meeting any other needs such as financial or safety. Hospice also provides medication and supplies as well as any medical equipment needed to provide comfort. Nursing staff is available 24 hours a day and are on call if the need arises.

I am not sure where your mom currently lives but hospice is available in her own home, in nursing homes, group homes and assisted living. Hospice also provides inpatient care either in a hospice facility or hospital for symptoms that are difficult to control. Hospice can also provide respite care outside of your home for five days or for someone to stay with your mom for short periods of time if you would need that.

Hospice will ask your mom if she has any goals: anything she would still like to do. The team will then work to help her accomplish that if possible. Some goals are as simple as contacting an old friend or it may be needing help to get her affairs in order, or someplace she would like to go. Often people get hospice late and as a result don't benefit as much as they could have from this special type of care.

Many people think that hospice is about dying but hospice staff feel it is about living. Hospice is really about making the most of each day surrounded by the people you love.

Today's question was answered by Sue Antram, RN, Director of Hospice Services.