What services are provided by JSSA Hospice? Our personalized services for patients and family members include:

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1 FAQ S ABOUT HOSPICE What is Hospice? Hospice is a specialized type of healthcare for patients and families who are faced with a terminal illness. A team of physicians, nurses, social workers, bereavement counselors and volunteers work together as a team to address the physical, social, emotional and spiritual needs of each patient and family. The interdisciplinary team provides care to patients in their own home, the home of a family member, a senior living residence or a nursing home. What is JSSA Hospice? JSSA Hospice our community s hospice to turn to for exceptional end-of-life care that supports dignity and comfort for individuals, provides peace of mind to families, and honors all cultural traditions and customs. For nearly 30 years, JSSA's hospice has offered outstanding end of life medical and support services, from symptom and pain management to emotional and spiritual guidance for patients and their families. What makes JSSA Hospice unique? JSSA s promise that each of our hospice nurses carry a small patient caseload is the commitment we make to you and your loved one. This hallmark ensures the highest quality of care and results in the most access to care. Smaller caseloads enable our staff to make more frequent and longer home visits, increase responsiveness to needs between visits and greater personalized attention. Our hospice scheduling is highly flexible to accommodate patient and family needs. Our hospice staff is specially trained to be sensitive to end-of-life religious and cultural traditions. Also, while JSSA Hospice is nonsectarian, our commitment to the Jewish community is rooted in nearly 120 years of expertise, compassion and Jewish values. JSSA Hospice staff understands Jewish rituals around end of life and addresses the physical, emotional and spiritual needs of patients and their families from this perspective. JSSA also offers a range of bereavement services that includes individual counseling and support groups. What services are provided by JSSA Hospice? Our personalized services for patients and family members include: Admission by registered nurses available seven days a week 24-hour nursing care accessibility Frequent and longer in-home nursing visits Comprehensive patient evaluations and assessments Collaboration with the patient's primary physician 1 P a g e

2 Instruction in pain and symptom management Care coordination and supervision Flexible scheduling to accommodate patient and family needs Ongoing medical consultation Coordination of medical equipment and supplies JSSA Hospice provides medications and non-pharmacologic treatment of symptoms Personal care assistance Nutritional guidance Volunteer companionship and respite care Pastoral counseling Emotional counseling and support Is JSSA Hospice available 24 hours a day? Yes. JSSA Hospice patients, caregivers and family members can communicate with JSSA Hospice by phone and . We are available by phone 24 hours a day at Who pays for JSSA Hospice services? JSSA Hospice care is covered under Medicare, Medicaid, most private insurance companies and other managed care organizations. In addition, JSSA provides hospice care to those who are without insurance or financial resources. Who cares for a hospice patient? From your very first phone call to JSSA s hospice, our compassionate and highly skilled team works attentively every step of the way in supporting you and your loved one s unique situation. Each team member reaches out, answers questions and anticipates concerns on a daily basis ensuring that you and your family s specific needs and individual preferences are honored. Our professionals, experts in current hospice practice, include: Medical directors/physicians Highly skilled registered nurses Experienced clinical social workers Certified nursing assistants skilled in end-of-life care Pastoral counselors/chaplains Extensively trained volunteers Where is hospice care provided? JSSA's hospice services are provided in private homes, senior living residences, assisted living facilities, and nursing homes (skilled nursing facilities) throughout Montgomery County. 2 P a g e

3 How do JSSA Hospice and JSSA work together? JSSA Hospice is one of many programs and services provided by JSSA. JSSA has been helping individuals and families across the Washington metropolitan area meet emotional, social, and physical challenges for 120 years. A nonsectarian provider, JSSA serves people of all religious backgrounds, races and ethnicities, helping the youngest child to the most fragile senior, from individuals to entire families. JSSA provides services and support through its Rockville, Silver Spring and Fairfax offices to nearly 37,000 individuals a year through a wide range of counseling, educational, employment, in-home support, nursing care, and social services. JSSA also offers a wide range of continuing education trainings for parents, educators, mental health providers and clergy. When you or a loved one choose JSSA Hospice, you are also choosing JSSA and in doing so have access to a comprehensive array of high quality and caring support services for the entire family. JSSA s experienced and compassionate clinical staff have years of experience in provide counseling, bereavement support and care management to children, teens, adults and families. When should a decision about entering a hospice program be made and who should make it? At any time during a life-limiting illness, it s appropriate to discuss all of a patient s care options, including hospice. By law the decision belongs to the patient. JSSA hospice accepts patients who have a life-expectancy of six months or less and are referred by their personal physician. What is a DNR/MOLST? JSSA Hospice works with individuals to determine their end of life wishes, including decisions about resuscitation. A DNR (Do Not Resuscitate) is a legal form in the State of Maryland, honored by EMTs (Emergency Medical Technicians), which allows the EMTs to institute comfort measures but does not mandate that CPR (cardiopulmonary resuscitation) be initiated. The DNR must represent the stated wishes of the patient, expressed directly or through the health care agent. The DNR is not a permanent document and may be revised or revoked by the patient or health care agent. Who is eligible for hospice care? Acceptance into hospice care requires a statement by a doctor and the hospice medical director that the patient has a life expectancy of 6 months or less if the disease runs its normal course. The patient must meet specific qualifications for their diagnosis as well. The patient is required to sign a statement saying that he or she is choosing hospice care, vs. pursuing curative treatment. Contrary to popular belief, hospice care can be continued if the patient lives longer than 6 months, as long as the hospice medical director or other hospice doctor attests to the patient s ongoing qualification. If I am in a nursing facility is hospice care available to me? Yes. Hospice care is available to individuals residing in a nursing facility, group home, assisted living, senior living residence, or a private home. 3 P a g e

4 Does hospice provide support to the family after the patient dies? Yes, JSSA provides 13 months of bereavement support to the family. Unlike other hospices, JSSA social workers continue to follow their families during the initial bereavement period. JSSA also offers a broad range of counseling options as well as bereavement support groups. MYTHS ABOUT HOSPICE CARE Myth: Hospice is a place. Reality: Hospice can be a place, but Hospice care usually takes place in the comfort of an individual's home, but can be provided in any environment in which a person lives, including a nursing home, assisted living facility, or residential care facility. Myth: Hospice means that the patient will soon die. Hospice hastens death. Reality: Receiving hospice care does not mean giving up hope or that death is imminent. The earlier an individual receives hospice care, the more opportunity the hospice team has to manage symptoms and provide holistic support. Myth: Hospice means giving up hope. Reality: Hospice is not about giving up hope. It may mean redefining hope when faced with a terminal illness. Rather than dwell on the imminent loss of life our staff helps patients and families determine what is most important to them at the time, and works collectively to make this happen. Hospice helps patients reclaim a spirit of hope. It helps them understand that sharing in this journey they may enrich their relationships and create opportunities for reminiscence, laughter, and the creation of cherished memories. Myth: JSSA Hospice is just for Jewish people. Reality: JSSA Hospice is nonsectarian and provides individualized end-of-life care without regard to race, gender, sexual orientation, age, religion, national origin, marital status, political belief, disability or any other basis in accordance with federal, state, and local regulations. Myth: Hospice is only for older people. Reality: While the majority of hospice patients are older, hospices serve patients of all ages. JSSA serves patients from age 18 and older. Many hospices offer clinical staff with expertise in pediatric hospice care. Only about 20% of hospice patients are under 65 years of age. Myth: Hospice is only for cancer patients. Reality: A large number of hospice patients have congestive heart failure, Alzheimer's disease or dementia, chronic lung disease, or other conditions. Myth: Hospice is only for those that are dying. Reality: As a family-centered concept of care, hospice focuses as much on the grieving family as on the dying patient. Myth: Hospice can only help when family members are available to provide care. Reality: Recognizing that terminally ill people may live alone, or with family members unable to provide care, many hospices coordinate community resources to make home care possible. Or they help to find an alternative location where the patient can safely receive care. 4 P a g e

5 Myth: Hospice is for people who don t need a high level of care. Reality: Hospice is serious medicine. Most hospices are Medicare-certified, requiring that they employ experienced medical and nursing personnel with skills in symptom control. Hospices offer state-of-theart palliative care, using advanced technologies to prevent or alleviate distressing symptoms. Myth: Patients can only receive hospice care for a limited amount of time. Reality: The Medicare benefit, and most private insurance, pays for hospice care as long as the patient continues to meets the criteria necessary. Patients may come on and off hospice care, and re-enroll in hospice care, as needed. Myth: Hospice is just for the patient. Reality: Hospice focuses on comfort, dignity, and emotional support. The quality of life for the patient, and also family members and other caregivers, is the highest priority. Myth: A patient needs Medicare or Medicaid to afford hospice services. Reality: Although insurance coverage for hospice is available through Medicare and in 44 states under Medicaid, most private insurance plans, HMOs, and other managed care organizations include hospice care as a benefit. In addition, through community contributions, memorial donations, and foundation gifts, many hospices are able to provide patients who lack sufficient payment with free services. Other programs charge patients in accordance with their ability to pay. Myth: A physician decides whether a patient should receive hospice care and which agency should provide that care. Reality: The role of the physician is to recommend care, whether hospice or traditional curative care. It is the patient's right (or in some cases the right of the person who holds power of attorney) and decision to determine when hospice is appropriate and which program suits his or her needs. Before entering a hospice, however, a physician must certify that a patient has been diagnosed with a terminal illness and has a life expectancy of six months or less. Myth: To be eligible for hospice care, a patient must already be bedridden. Reality: Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient's physical condition. Many of the patients served through hospice continue to lead productive and rewarding lives. Together, the patient, family, and physician determine when hospice services should begin. Myth: After six months, patients are no longer eligible to receive hospice care through Medicare and other insurances. Reality: According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, he or she can continue receiving hospice care as long as the attending physician recertifies that the patient is terminally ill. Medicare, Medicaid, and many other private and commercial insurance plans will continue to cover hospice services as long as the patient meets hospice criteria of having a terminal prognosis and is recertified with a limited life expectancy of six months or less. Myth: Once a patient elects hospice, he or she can no longer receive care from the primary care physician. Reality: Hospice reinforces the patient-primary physician relationship by advocating either office or home visits, according to the physician preference. Hospices work closely with the primary physician and consider the continuation of the patient-physician relationship to be of the highest priority. 5 P a g e

6 Myth: Once a patient elects hospice care, he or she cannot return to traditional medical treatment. Reality: Patients always have the right to reinstate traditional care at any time, for any reason. If a patient's condition improves or the disease goes into remission, he or she can be discharged from a hospice and return to aggressive, curative measures, if so desired. If a discharged patient wants to return to hospice care, Medicare, Medicaid, and most private insurance companies and HMOs will allow readmission. We acknowledge HospiceDirectory.org and AmericanHospice.org for providing some of the above information. Jewish Social Service Agency For the best in hospice care Think JSSA P a g e