Dignity Health
  • Hospice FAQs

    Hospice FAQs

    Please scroll down to view Starlight Pediatric Program FAQs and Veteran FAQs


    Q: How will my family and I know when it is time for hospice?

    A: Once a serious or terminal illness is diagnosed, the patient, family or physician may call for hospice. Hospice is appropriate when the doctor believes that the remaining life span is measured in months instead of years and when the patient is ready to move from curative treatments to care that focuses on comfort and symptom relief. Making the call for hospice isn’t easy, but you should not wait until death is imminent. For those who want to spend their final days, weeks or months at home with their loved ones, hospice is the best resort, not the last.


    Q: What are some illnesses that qualify for Hospice Services?

    A: Hospice is appropriate when the doctor believes that the remaining life span is measured in months instead of years and when the patient is ready to move from curative treatments to care that focuses on comfort and symptom relief. Diagnoses can include Heart Disease, Pulmonary/Lung Disease, Kidney Disease, Liver Disease, Stroke/Coma, Dementia/Alzheimer’s, ALS, Caner or HIV. Pediatric diagnoses can include Heart Disease, Central Nervous System abnormalities, Chromosomal Abnormalities,  Respiratory Failure, Kidney or Liver Disease, Cancer and HIV.


    Q: Our mom needs hospice, but she’s afraid and refuses to consider what she calls a last resort. What can we say to help ease her fears?

    A: You can tell her that hospice care will keep her comfortable and at home with her loved ones instead of in a hospital. You can remind her often that if her condition improves or if she changes her mind, she may discontinue hospice care at any time. And you can tell her that hospice is a gift she gives to herself and her family because hospice care supports the caregivers as well as the patient. Finally, you can tell her that hospice is to death what Lamaze is to child birth – a level of comfort care that allows us to face the end-of-life experience without pain and without fear.


    Q: I heard hospice comes on board only a day or two before someone dies. Is that true?

    A:  This is one of the biggest myths of hospice care, one we struggle with all the time. Unfortunately, when people hear the word “dying,” they define that as that final day or two before a person passes away. In reality, death often doesn’t occur for weeks, months or even years after a terminal diagnosis. Hospice care is much more effective, for both the patient and the family, if services are started sooner rather than later. The day a terminally ill patient and his family choose comfort care at home, over curative care in a hospital, we’re there.


    Q: Does hospice do anything to make death come sooner?

    A: Absolutely not. Hoffmann Hospice celebrates the sanctity of life and we neither hasten nor prolong death. In fact patients served by hospice actually increase their days, according to a March 2007 study by the Journal of Pain and Symptom Management. The study found hospice patients live an average of one month longer than terminally ill patients who don’t use hospice. Our focus at Hoffmann is on symptom control and pain management, allowing patients to live pain free with an enhanced quality of life.


    Q: Must a patient’s physician recommend the patient to Hoffmann Hospice?

    A: No, anyone can make the first call to hospice including a patient, family or friend. However, a physician must approve hospice care for the patient. If your physician wants more information about hospice care, it is available from the National Hospice and Palliative Care Organization.


    Q: Who are the hospice team members and do I have to stop seeing my personal doctor?

    A: Hospice teams are made up of specially trained doctors, nurses, hospice aides, spiritual counselors, social workers and volunteers who provide both compassionate and high-quality care. The care that the team provides is specific to the patient and family’s individual needs. Your personal doctor may also be a part of the hospice team and can remain as your attending physician.


    Q: Is it true that if I go on hospice care, I must stop all my medications and treatments?

    A: When on hospice care patients are provided with whatever is needed to manage their pain and enhance their quality of life. Tom Hoffmann, Cofounder and Administrator of Hoffmann Hospice, is a pharmacist by trade and works closely with the patient’s clinical team and doctors to provide the medications necessary to comfortably manage their symptoms yet allow them to stay alert and oriented. The decision to discontinue medications and treatments are made on a case-by-case basis and depend on patient need and stage of the disease. It may be appropriate for patients to receive curative treatments not related to their terminal diagnosis, but, at this point in their lives, most patients do not want to pursue heroic measures.


    Q: Is it true that patients receiving hospice care must first have a Do Not Resuscitate order signed by a physician?

    A: No it’s not. Patients do not need to have a DNR order signed at the time of enrollment into hospice. Often, physicians rely on hospice to get a DNR order because they are reluctant to have the discussion with the patient. However, our staff will work with the family to determine the best time to have a DNR order signed. Hoffmann Hospice will not refuse a patient because they do not have a DNR order.


    Q: If a patient shows signs of recovery or chooses to return to seeking curative treatment, can they stop hospice services?

    A: Certainly! A patient may choose at any time to discontinue hospice services. New treatment options may become available which the patient may elect to seek or a patient’s condition may improve. In either case, the patient can be discharged from hospices services and should they need to return to hospice at a later time, most insurances including Medicare will allow the additional coverage.


    Q: Can a hospice patient who shows signs of recovery, or simply changes his mind about Hospice care, return to regular medical treatment?

    A: Yes, of course. When patients show signs of recovery and receive an extended prognosis, they may be discharged from hospice services. At Hoffmann Hospice, the patient is captain of the ship and may revoke hospice services at any time to seek curative care. Once the patient then concludes a cure is no longer possible or wants to discontinue regular medical treatment, he or she may return to hospice service at any time.


    Q: What are some of the questions I should ask when selecting a hospice?

    A: When dealing with an end-of-life illness each of us has different medical, emotional, financial and spiritual needs. When choosing a hospice it’s important to be open about those needs. Ask about payment requirements, spiritual counseling and, most importantly, about after hours services. It may also be beneficial to ask about a hospice’s profit status, as there is significant evidence that nonprofit hospices provide more services than for-profit hospices.


    Q: In light of healthcare reform, is hospice covered by my insurance?

    A: Yes, Medi-cal and most private insurances carry a hospice benefit. Carriers such as Blue Shield, Anthem, United Healthcare, Kaiser, Gemcare, BFMC, the VA and Healthnet all include hospice coverage. Additionally, if you are 65 and over and have Medicare as a primary or secondary insurance your hospice care is covered by your insurance. If a loved one in your family has a serious illness contact Hoffmann Hospice as a resource to learn more about your healthcare options.


     Q: Is hospice covered by insurance?

    A: Hospice is covered by Medicare, Medicaid in most states and by private insurances including HMO’s. Be sure to call your insurance provider for coverage. You may also call a hospice in your area that can assist you and your family in finding out whether or not hospice services are covered. Barring this, many hospices will provide services even when a patient is not insured.


    Q: I know hospice is covered by my insurance, can I choose the hospice agency that I want for my loved one?

    A: According to Federal Statutes and the Balanced Budget Act of 1997, if you are 65 or older and Medicare is your primary insurance, you have the right choose the hospice agency that you and your family feel most comfortable with. Hoffmann Hospice is contracted with the majority of insurance providers including Blue Shield, Anthem, United Healthcare, Kaiser, Gemcare, BFMC, the VA and Healthnet. All of which have a hospice coverage benefit regardless of the patient’s age. If a loved one in your family has a serious illness contact Hoffmann Hospice as a resource to learn more about your healthcare options.


    Q: What about those who cannot afford to pay for hospice services?

    A: As an independent, community-based non-profit hospice, Hoffmann Hospice accepts eligible hospice patients, regardless of their ability to pay, based on the availability of funds donated by individuals, businesses and foundations in the community.


    Q: Is it true that hospice patients must revoke hospice service if they go to the emergency room?

    A: Not necessarily. Hospice patients may go to the emergency room to seek care for an injury or condition not related to their hospice diagnosis. For example, if a patient has a terminal diagnosis of cancer, but falls and breaks an arm, he may absolutely go to the ER for treatment of the broken arm. But if that same patient goes to the ER to seek treatment for the cancer, then, yes, he revokes hospice service. Remember, hospice care steps in when a cure is no longer realistic and the patient has decided he no longer wishes to pursue curative measures.


     Q: We are considering hospice for my husband but I am worried about our 2 small children, that it may frighten them. How do I make sure that they are not lost in the shuffle?

    A: We completely understand your concern and we have recognized this need in families already served. Hoffmann Hospice has implemented a wonderful service called the Buddy Brigade. Hoffmann Hospice patients, who have children or siblings in the home, are immediately connected with a volunteer where they will have special time that they can call their own and engage in activities that they enjoy in the comfort of their home. These activities can range from playing a board game, outdoor activities or just hanging out watching TV. This program is offered through our Volunteer Department which includes specialized training and extensive background checks. Hoffmann Hospice’s goal has always been to support the entire family in addition to the patient.


    Q: It’s my understanding hospice not only cares for the patient, but for the patient’s family as well. Will that care end when my loved one dies?

    A: No it won’t. Hoffmann Hospice is committed to guiding our families through the end-of-life process, especially their grief, for up to 13 months after the death of their loved one. We keep in close touch with our families, contacting them monthly and providing one-on-one support when necessary. Our families also have access to Hoffmann’s well-stocked bereavement resource library and are invited to special events throughout year, including our holiday grief support luncheon, our Christmas ornament decorating party and, of course, our weekly support group meetings for adults and children. Our families are as important to us as our patients and it shows in our bereavement program.


    Q: Is there a right way and a wrong way to handle grief after the loss of a loved one?

    A: Personalities and life experiences influence the way each of us deals with grief. Each person’s style of grieving must be respected so, in this sense, there is no right or wrong way to grieve. Generally, however, the amount of support a person receives can lessen the impact of grief and facilitate recovery. That is why we highly recommend our weekly grief support group meetings, which are open to the public.


    Q: Does hospice care only for patients who live in private homes?

    A: Not at all. Hospice care teams go where our patients live – their private residence, skilled nursing facilities, residential care facilities, board and care homes, hotels or motels. We even cared for a patient living in a motor home at the Kern County Fair. When you’re on service with Hoffmann, we’ll meet you wherever you call home.


    Q: My mom lives in a skilled nursing facility and was recently diagnosed with a terminal illness. What more can you do for her that the facility’s staff is not already doing?

    A: We offer comfort for the patient and peace of mind for the family beyond what you might expect. When the resident of a skilled nursing facility begins to decline and he or she desires comfort care rather than hospitalization or aggressive treatment, Hoffmann staff specializes in managing that comfort and enhancing the care provided by facility staff.


    Q: How long can a patient stay on hospice service?

    A: Indefinitely. Our patients may continue to receive hospice care as long as they meet hospice criteria. Once on service, they are evaluated on a regular basis by our team of medical professionals. Whenever removing a patient from hospice care is a possibility, patients and their families are always involved in the decision. There is never a rush. In fact, some of our patients have been with us for months.


    Starlight Pediatric Program FAQs


    Q: Who is eligible for the Hoffmann Hospice Starlight Pediatric Program?

    A: Children and adolescents from birth to 20 years of age who have a life-limiting medical condition or illness are eligible for the program. Such illnesses include but are not limited to heart diseases, lung diseases, neurological disorders, genetic and metabolic disorders, cancers and tumors. In many cases, families may continue to seek curative treatment (Concurrent Care) while on hospice.


    Q: Why should our family choose Hoffmann Hospice for our child’s care?

    A: Hoffmann Hospice is the only local non-profit hospice choice in Kern County and the Antelope Valley that cares for pediatric patients with life-limiting medical conditions. Our extensively trained pediatrics team is led by our Pediatric Medical Director Dr. Sudhir Patel to ensure the best possible care for children/adolescents and their families. At Hoffmann Hospice, we have been caring for children and their families since 1995.


    Q: When is it time to call Hoffmann Hospice for my child?

    A: It is never too soon to learn about hospice care options for your child and family. Children and adolescents from birth to 20 years of age who have a life-limiting medical condition or serious illness are eligible for the Starlight Pediatric Program at Hoffmann Hospice. Such illnesses include but are not limited to heart diseases, lung diseases, neurological disorders, genetic and metabolic disorders, cancers and tumors. In many cases, families may continue to seek curative treatment (Concurrent Care) while on hospice. Anyone can refer a child to hospice and we work closely with your child’s specialists to ensure the best possible care.


    Q: How will Hoffmann Hospice care for our child and family?

    A: Caring for a child with a serious illness may seem like more than a family can handle. With hospice, you are not alone. Our Pediatric teams including doctors, nurses, social workers, clergy and volunteers are here to provide the coordinated care and support that you need. Hospice is not about “giving-up”, it is changing the focus to helping your child live as full and pain-free a life as possible.


    Q: How is hospice care for my child paid for?

    A: Hospice care is covered by most insurance plans including private insurance and Medi-Cal. As a non-profit, Hoffmann Hospice will accept eligible children and adolescent patients regardless of their ability to pay.                      


    Veteran FAQs


    Q: What unique needs do veterans have at the end of life and how does Hoffmann Hospice meet them?

    A: At the end of life, many veteran hospice patients need support with medical, emotional, spiritual and psychological needs that differ from a civilian hospice patient. These include needs dependent upon the specific war that they served in, trauma they experienced, service-related diseases and the needs of homeless veterans. The Hoffmann Hospice teams, some of which are veterans and veterans’ spouses along with Veteran to Veteran volunteers, receive continued training so that they are able to meet the unique needs of veterans and their families. Most importantly, the hospice team has a genuine compassion for veterans and that compassion led Hoffmann Hospice to meet their goal of receiving the highest level within the We Honor Veterans program of the U.S. Department of Veteran Affairs and the National Hospice and Palliative Care Organization.


     Q: What is the Veteran to Veteran Volunteer Program at Hoffmann Hospice?

    A: The Veteran to Veteran program at Hoffmann Hospice is an elite group of male and female volunteers who are veterans. They volunteer their time to help veteran hospice patients and their families by providing companionship and caregiver relief. Veteran patients usually feel a higher level of connectedness with a veteran volunteer and enjoy the comradery. The most valuable benefit to a veteran at this season of his life is the opportunity to share military stories with another veteran as some military stories are not usually shared with family and friends. Veteran volunteers also participate in veteran community events to maintain partnerships in the community and maintain awareness of all veterans’ services and resources.


    Q: My father is a veteran and his physician referred him for hospice services; how can Hoffmann Hospice meet the needs of a veteran?

    A: Veterans receive the same hospice services which include a personal care team including Physician services, Social services and Spiritual care, comfort care for pain and symptom management, medical equipment and medications, 24 hour access to hospice nurses and Veteran to Veteran volunteers. Services specific to our veteran patients include help with assessment of VA benefits eligibility, coordination with the VA to receive services, support with veteran burial benefits including burial at a national Cemetery, support with veteran resources, assistance with the Honor Flight application, connecting veterans and celebrating a veteran’s finest moments with honorary ceremonies provided by Hoffmann staff. Emotional and Spiritual support for veteran patients are customized based on the war they fought in, trauma experienced and service-related diseases. Hoffmann Hospice is very active in the veteran communities they serve in order to ensure that they are up to date on the latest veteran services.


    Q: I am on hospice service and am the wife of a veteran. Am I eligible for veteran benefits?

    A: Yes, you may be eligible for veteran benefits. Your Hoffmann Medical Social Worker will ask you several questions in order to connect you with VA benefits. They will also help you obtain and complete the necessary paperwork which will determine if you are able to receive Aid and Attendance Benefits.


     How are we funded?


    Hoffmann’s services are funded, in part, by Medicare, Medi-Cal and commercial insurance reimbursements. Although some insurance programs include a hospice benefit, in many cases the patient care is non-funded. The remainder of oufunding is derived from memorial contributions, private donations, grants and annual fundraising events.

        Donations to Hoffmann Hospice support the following services:

    • Patient and family care; RNs, LVNs, home health aides, chaplain services and social services.
    • Thirteen-month follow-up bereavement care.
    • Medical equipment and supplies
    • Ambulance transport
    • Medications

    At Hoffmann, our goal is never to deny care to those in need. Every donation is deeply appreciated and supports the non-profit work of servicing the terminally ill and their families.

    Additional issues for consideration include:

    The individual or representative must sign a consent form electing to participate in the Hospice program.

    The patient’s home environment must be reasonably safe, conducive to Hospice care and free from risk to staff life or health. Risks may include animals that bite, guns, excessive drinking or infestation. It is at the discretion of the     healthcare  professional to determine if the home is a safe environment for practice. Non-compliance may be considered a cause for termination of service.

    The individual must live within the areas of served by Hoffmann Hospice. Please refer to the Contact portion of the website for Service Areas.