Hospice of Kankakee Valley - Frequently Asked Questions

What is hospice?
Hospice is a special way of providing medical, emotional, social, and spiritual care to persons and families who are living with terminal illness. Its aim is palliative (for comfort), not curative. Hospice of Kankakee Valley is committed to providing quality, wholistic, patient and family-focused service through an aggressive plan of comfort care, while maintaining the dignity and independence of the patient and family.

Isn’t hospice care only for patients with cancer?
No. Although on average 44% of the patients admitted to Hospice of Kankakee Valley have conditions related to cancer, last year 62% had other diagnoses including heart and lung disease, AIDS, stroke, dementia, liver disease, and Lou Gehrig’s disease (ALS), as well as overall decline in condition and other diseases at end stage.

Is hospice care only for adults?
No. Hospice serves eligible patients of any age. This includes infants, children, and young adults.

Does the patient have to be in a hospital or nursing home?
No. The hospice philosophy is based on the belief that patients with advanced illness can live and die among friends and family in familiar surroundings, and centers on the desire that the patient’s last days be spent in comfortable dignity at home, or in a home-like setting, including nursing homes, inpatient hospice facilities, and infrequently hospitals. Since the entire family is the focus of care, all family members, including children, benefit from Hospice care.

Do I have to wait for my physician to tell me about hospice care?
While anyone can make a referral call, the decision to choose hospice should be made by the patient and family, with the input of their physician. Throughout the course of the illness, open and honest discussion about treatment options is very important, and that includes the benefits and burdens of treatment, as well as the option of choosing hospice care when the time is appropriate. If a patient or family feels the physician is reluctant to discuss hospice care, it is always appropriate for one or the other to broach the subject or call HKV for consult or information.

It is important to talk about end-of-life care with your loved ones and your physician so they will know your wishes. Talking about hospice care and other treatment options before care is needed may make the decision easier for you or a loved one. Hospice of Kankakee Valley offers complimentary copies of the Five Wishes Healthcare Power of Attorney form, a user-friendly advance directive that uses plain language to guide the user through expressing his or her wishes for care and becomes a legal document when signed by the participant. HKV periodically offers educational sessions explaining the implementation of Five Wishes. Call the HKV office at (815) 936-3370 to sign up for a session or to request a copy of Five Wishes.

When is the best time to make the decision about hospice care?
It is appropriate to discuss all of a patient’s care options at any time during a life-limiting illness. It is never too early to call for information. People who utilize hospice services early in the course of a life-limiting illness have more time to develop personal and professional rapport with supportive staff and volunteers, discuss end-of-life goals, and create an optimal plan of care designed around patient and family wishes. By law, the decision to choose hospice care belongs to the patient.

Is assisted suicide an element of hospice care?
No. The hospice philosophy of care aims to keep the patient as comfortable and independent as he or she wishes during the natural course of the terminal disease. Hospice seeks neither to hasten nor prolong the dying process. The prevailing fears many people have about death are the fear of dying in pain, the fear of being isolated from others, the fear of being a financial burden, and the fear of loss of control. Hospice of Kankakee Valley addresses these fears by providing expert pain and symptom control, offering companionship and emotional support to the patient and family, providing services regardless of ability to pay, and designing a plan of care dictated by the wishes of the patient. Hospice helps people live until the last moment of their lives.

How does hospice manage pain?
Every member of the Hospice of Kankakee Valley team is trained to assess for pain and other uncomfortable symptoms. Hospice nurses and doctors are up-to-date on the latest medications and devices for pain and symptom relief, and are experienced in recognizing signs of pain (verbal and non-verbal). HKV staff, the patient, and the family work together to set goals for the management of pain and treat pain promptly and effectively, enabling the patient to remain comfortable while participating in activities as he or she chooses. Hospice believes that emotional and spiritual pain are just as real as physical pain and offers the help of counselors and clergy.

How long do hospice patients live?
Depending on the progression of the disease and the time of referral, the length of stay in hospice care varies greatly. Some people believe that a person qualifies for hospice only if he or she is bedridden, unable to care for him/herself, or acutely dying. This is untrue. Many of our patients are still quite mobile, are able to care for themselves, and can participate actively in daily living. A few patients have lived over two years in our care while continuing to meet hospice guidelines. Early referral to Hospice of Kankakee Valley can help ensure that a patient receives the maximum benefits available.

No one can accurately predict how an illness will run its course or how long a person will live, but in accordance with Medicare regulations a physician must certify that, to the best of his or her knowledge, the patient will live six months or less if the disease progresses naturally. This does not mean that a hospice patient cannot live longer than six months. Patients can be recertified and remain under the care of hospice if they continue to meet certain criteria specific to their illness. Occasionally, a patient’s condition will improve so that he or she no longer meets qualifications for hospice care. If this occurs, the patient can be discharged and readmitted when hospice care is needed again.

Recently the law was changed to extend qualifications for hospice care in Illinois from six months to one year. We are hoping that Medicare will follow suit to allow one year of benefits nationally. Sadly, however, the reality is that many patients come to hospice just days or hours before death. When a patient is referred to hospice care very late in the disease, sometimes the patient and family’s priority is to focus on bringing pain and symptoms under control, and there is little time to develop a plan of care that incorporates the patient’s and family’s emotional, spiritual, and social well-being. While we believe that a patient can benefit from even one day of hospice care, we know that optimal wholistic care is best achieved when a referral is made early.

Do most hospice patients die at home?
Yes. Hospice of Kankakee Valley is primarily home-based. If pain and symptoms cannot be controlled at home, patients can be hospitalized; however, this is extremely rare: less than one percent of HKV care days were spent in the hospital over the past year. We also have contracts with Momence Meadows, Provena Heritage Village, Miller Center, Provena Our Lady of Victory Nursing Home, Manor Care Health Services, Bourbonnais Terrace, Merkle Knipprath, and the Illinois Veteran's Home at Manteno, and serve people who call these facilities home.

Who pays for hospice care?
In accordance with our Mission, Hospice of Kankakee Valley provides services regardless of ability to pay, thanks to the generous support of our community. Medicare and Medicaid have a Hospice Benefit that covers care, supplies, and medications related to the terminal illness. Many private insurance plans also pay for hospice care. Medicare and Medicaid recipients are never billed for hospice services, and the cost for patients who do not qualify for Medicare, Medicaid or insurance, or who owe co-pays or deductibles, is determined on a sliding scale.

Can I choose to discontinue hospice care once I am admitted?
Certainly. Patients have the right to revoke hospice services if they wish to pursue other treatment options. A patient may also be discharged if his or her condition improves or does not decline as expected, and can be readmitted later if he or she still qualifies. Also, a patient who lives longer than the physician’s prognosis – studies show that patients benefiting from the personalized supportive care of hospice often live longer than those who do not use hospice services – may be recertified and can continue hospice care as long as they qualify.

Although surveys show that 80-95% of people would choose to die at home, Hospice of Kankakee Valley served around 30% of the people who died last year in Kankakee County. Only 10% of people die suddenly; many more could fulfill their wishes of a comfortable death at home if they utilized hospice services. Currently, more than 50% of Americans die in hospitals.
Hospice of Kankakee Valley provided expert palliative (comfort) care to over 477 patients and families in 2006 and provided 2,664 grief support services through HKV’s Bereavement program (grief support services are available to anyone in the community who has suffered a recent loss).
A study published in the Journal of Pain and Symptom Management found that the mean survival was 29 days longer for hospice patients than those who chose not to elect hospice care. More importantly, they were spared much painful, expensive, and intrusive treatment, and they could lean on the compassionate support offered by hospice staff and volunteers.
A 2004 University of Pittsburgh study in the Journal of Medical Care revealed that on average interviewees were willing to trade seven months of healthy life just to ensure better quality of care in the final month of life. A “good death” is most precious, and it can happen with Hospice of Kankakee Valley.