Frequently Asked Questions
- Where is hospice care provided?
- What is palliative medicine?
- What is the role of nurse on the care team?
- What is the role of the medical social worker on the care team?
- How are the patient's personal care needs handled?
- What is a "caregiving plan"?
- How is spiritual care provided?
- What bereavement or grief care services are available and to whom?
- What if the patient needs hospitalization?
- What if a patient under your care lives beyond six months?
- Does your organization care for children?
- What grief programs do you have for children?
- What kind of community education is provided?
- How does a patient come under hospice care?
- Does a patient need to be close to death to be referred to Hospice & Palliative Care Charlotte Region?
- What is the next step after a physician approves a referral to Hospice & Palliative Care Charlotte Region?
- Can a patient be admitted directly to HPCCR from the hospital?
- Why is it more beneficial to come under hospice care early in the disease process, once a life expectancy of six months or less is determined?
- What other life threatening illnesses, besides cancer(s), are appropriate for hospice care?
- What role does the primary physician play once a patient comes under care?
- How is Hospice & Palliative Care Charlotte Region licensed?
- Does your organization have accreditation?
- What role do volunteers play?
- How is hospice care funded?
- How does your organization support the non-reimbursed services provided?
- What if a person does not have Medicare, Medicaid, or private insurance?
- What non-reimbursed services does Hospice & Palliative Care Charlotte Region provide?
- Does hospice care make death come sooner?
- What is the difference between hospice care and home health services?
- What is a "Do Not Resuscitate Order" (DNR)?
- What is a Living Will/Health Care Power of Attorney?
- What is the Medical Orders for Scope of Treatment (MOST)
Q. Where is hospice care provided?
HPCCR provides hospice care in the home, in long-term care communities, in hospitals, and in our inpatient hospice houses -- Levine & Dickson Hospice House - Huntersville and Levine & Dickson Hospice House at Southminster.
Q. What is palliative medicine?
Palliative medicine is health care for individuals of any age who have a chronic, life-limiting illness. Palliative medicine is active care. It is care that aggressively seeks to improve quality of life by focusing on physical symptoms as well as emotional, social, and spiritual needs. While palliative medicine emphasizes pain control and other symptom management, patients do not have to forgo curative or restorative care. Palliative medicine also reaches out to address the needs of family members and caregivers to maximize support to the patient. Palliative medicine is provided by our Palliative Medicine Consultants program.
Q. What is the role of nurse on the hospice care team?
Our staff nurses provide intermittent skilled nursing visits for pain and symptom management, plus education regarding care of the patient.
Q. How are the patient's personal care needs handled?
When ordered by a physician, we provide certified, in-home aide services to help patients with personal care, including bathing, skin, mouth, and hair care.
Q. What is a "caregiving plan"?
When a patient comes under hospice or palliative care, a plan of care is developed based on the needs of the patient and their family. This plan outlines the multilevel, clinical services that will be provided, and it is updated regularly to reflect the changing needs of the patient and family.
Q. What is the role of the medical social worker on the hospice care team?
Our social workers provide counseling and support to the patient and family, including children, during this stressful time. Services may include assistance in identifying community resources, advice regarding financial, legal, and caregiving concerns that occur with a prolonged illness, as well as other individual services as appropriate.
Q. How is spiritual care provided?
Our staff chaplains provide and/or coordinate spiritual care for patients and families by helping them find the spiritual comfort, strength, and hope consistent with their own values, beliefs, and practices. Spiritual care can also offer the support needed to explore, clarify, or resolve spiritual issues of concern.
Q. What bereavement or grief care services are available and to whom?
We recognize the special needs of those who have experienced the death of a loved one, and we provide the individual and group support necessary to face grief. Grief services are available to families and loved ones of our patients, and are also available to anyone who resides in our community.
Q. What if the patient needs hospitalization?
If hospitalization is needed, the care team will coordinate this transition and maintain contact with the patient and their family during the patient's stay in the hospital. We have contracts with all hospitals in our service area.
Q. What if a patient lives beyond six months?
When the patient's physician signs the hospice certification, it signifies that he/she believes that, in their best medical estimate, life expectancy is six months or less if the illness takes its expected course. However, patients will not be discharged from our care if they exceed that time frame, as long as they meet the criteria for receiving hospice care.
Q. Does your organization care for children?
Hospice & Palliative Care Charlotte Region is the only provider of a specialized children's program in our eight-county service area. The Kids Path® children's program specializes in caring for the unique needs of seriously ill children and their loved ones.
Q. What grief programs do you have for children?
We offer individual sessions for children, grief camps for ages 7-16, and short term grief support groups in partnership with schools.
Q. What kind of community education is provided?
Our specially trained staff and volunteers give presentations to civic groups, long term care communities, businesses, communities of faith, and other groups who want to learn more about our services and programs. For more information about arranging a speaker, please call 704.375.0100.
Q. How does a patient come under hospice care with Hospice & Palliative Care Charlotte Region?
To come under the care of HPCCR, a person must live in one of the eight counties we serve, have a prognosis of months rather than years, and not be seeking curative treatment. A physician's orders are needed to come under care, but anyone can make a referral to Hospice & Palliative Care Charlotte Region. Once we recieve a referral, an assessment is scheduled between a nurse and the patient. If the patient is deemed appropriate for hospice care, the admission process begins. If necessary, we can call the patient's physician to obtain the orders for hospice care.
Q. Does a patient need to be close to death to be referred to Hospice & Palliative Care Charlotte Region?
No. In fact, early referral is beneficial to the patient and the patient's family. Hospice is appropriate for patients with a six months or less prognosis, but unfortunately many patients are referred for the last few days or even hours of their lives. It's important to know, however, that when a patient comes under care and symptoms are managed appropriately, quality of life is greatly enhanced. Studies have shown that patients who come under hospice care earlier can live longer than patients who come under care during their last days.
Q. What is the next step after a physician approves a referral to Hospice & Palliative Care Charlotte Region?
Our referral center coordinator will call to set an appointment with the patient, the patient's caregiver (usually a designated family member), and other family members. A referral center admissions nurse will then visit the patient where they are residing, whether home, facility, or hospital, and complete a detailed physical assessment of the patient's condition. Our various services are described, questions are addressed, and the patient can choose to come under our care at that time. One of the patient's caregivers must attend the initial assessment, which can be scheduled after business hours and on weekends. Family members are encouraged to be present.
Q. Can a patient be admitted directly to HPCCR from the hospital?
Yes. We work with hospital discharge planners and social workers to assess the support needed for the patient when leaving the hospital. If hospice services are deemed appropriate, the patient can be admitted directly to HPCCR for care.
Q. Why is it more beneficial to come under hospice care early in the disease process, once a life expectancy of six months or less is determined?
Hospice is a holistic approach to end-of-life care, in the home or home-like setting, addressing the physical, emotional, psychosocial, and spiritual needs of the patient and their family. Given the excellent care that a patient receives under our care, the patient and the family will both benefit from a longer relationship with our care team. Therefore, it is important once a diagnosis and prognosis is determined, to discuss the hospice option of end-of-life care with your physician.
Q. Do you only care for cancer patients?
No. Other disease categories may include, but are not limited to, end-stage cardiac, pulmonary, liver and renal diseases, stroke and coma, as well as amyotrophic laterial sclerosis (ALS), and other end-stage neurological diseases, Alzheimer's Disease, and AIDS. We accept patients with any life threatening illness resulting in an expected prognosis of six months or less for hospice care.
Q. What role does the primary physician play once a patient is admitted to hospice care?
The primary/referring physician is an integral part of the patient's care team. Team members update and consult with the physician on a regular basis.
Q. How is Hospice & Palliative Care Charlotte Region licensed?
We are licensed by the states of North and South Carolina to provide hospice care to persons with terminal illness and support services to patients' loved ones. We are also licensed in North Carolina to provide home health services. Yearly reviews of our policies, procedures, and record keeping are conducted. We have a Department of Quality Improvement which monitors all aspects of the agency's operations.
Q. Does your organization have accreditation?
We take quality seriously and are accredited by the Accreditation Commission for Health Care, Inc. (ACHC) Established in 1986, the goal of ACHC is to provide patient-focused, provider-friendly, educational accreditation programs. ACHC is committed to ensure that health care providers are adhering to the highest standards to benefit consumers.
Q. What role do volunteers play?
HPCCR has over 400 active trained volunteers who provide a variety of services to patients and their families. These services include, but are not limited to, regular visits to patients for companionship and support, respite for caregivers, and transportation for errands and medical appointments. Special skill(s) volunteers provide unique services like massages, hair styling, home repairs and yard care, notary services, language interpreters/translators, meal preparation, and much more. Other volunteers support our office staff with fundraising and public speaking, and visit patients in long term care facilities. For more information about volunteer opportunities, please call our volunteer services department at 704.375.3578.
Q. How is hospice care funded?
Some of our services are covered by reimbursements from Medicare, Medicaid, and private insurance. Those on Medicare and Medicaid may be eligible for a special hospice benefit. Donations from the community are another important means of financial support for our programs.
Q. How does your organization support the non-reimbursed services provided?
We seek contributions from individuals, foundations, corporations, communities of faith, and civic organizations to help pay for services not covered by reimbursements. Memorials, donations, bequests, planned gifts, and other contributions are gratefully received and are important sources of funding. Grants received for specific needs/projects and special events, sponsored by or for Hospice & Palliative Care Charlotte Region, also provide needed financial support.
Q. What if a person does not have Medicare, Medicaid, or private insurance?
Payment for services not covered by insurance is based on the patient's ability to pay. Those eligible for care are not denied our services because of an inability to pay.
Q. What non-reimbursed services does Hospice & Palliative Care Charlotte Region provide?
While some medical services may be reimbursed through private insurance, Medicaid, or Medicare, we must raise in excess of $1.7 million each year in order to provide comprehensive medical and support services to our patients, their families, and our community. Programs paid for by community support include medical care for children and patients without sufficient insurance, community education, spiritual and bereavement care, our grief camps for children who have lost a loved one, plus staff and volunteer training.
Q. Does hospice care make death come sooner?
No, hospice care neither speeds up or slows down the dying process. However, death is a natural part of life. Just as doctors and midwives lend support and expertise during the time of childbirth, we provide our presence and specialized knowledge during the dying process.
Q. What is the difference between hospice care and home health services?
Hospice care is a specialized type of health care that focuses on quality end-of-life care for individuals facing a terminal illness, and support for their families. It offers a unique, multifaceted approach to caring for the whole person, including the management of pain and other physical, emotional, psychosocial, or spiritual symptoms. Home health care focuses on a rehabilitative model of care, providing primarily skilled nursing services and therapies with a goal of resolving the problem within a specified time period.
Q. What is a "Do Not Resuscitate Order" (DNR)?
A DNR is an order, signed by the patient's primary physician, which states that in the event of death, CPR will not be attempted. Patients do not need to have a DNR order to be under the care of Hospice & Palliative Care Charlotte Region.
Q. What is a Living Will/Health Care Power of Attorney?
A Living Will states the wishes of the patient regarding a desire for a natural death. A Health Care Power of Attorney legally appoints a surrogate if the patient is unable to make medical decisions. Contact us at 704.375.0100 for additional information regarding advance care planning.
Q. What is the Medical Orders for Scope of Treatment (MOST)
The MOST is a physician order, issued by a physician, physician assistant, or nurse practitioner. It covers a range of treatments from antibiotics, artificial nutrition, and attempted resuscitation, to full comfort measures. The MOST is signed by both the patient (or patient representative) and the health care professional preparing it. The MOST is reviewed yearly by the patient or patient representative and the current health care provider. If more than a year passes without review, the MOST is considered void. Since the original order must be used for each review, the MOST stays with the patient at all times. Easily recognizable, the MOST is a bright pink form that should be kept either at the front of the patient chart of near the bed. If the patient is at home, the MOSTshould be posted in an obvious and visible location. If other advance directives have been created, those should be attached to the MOST if possible.