Frequently Asked Questions

General Questions:

Questions about care given:

Questions about greiving:

Misconceptions About Hospice Care:

If your question is not addressed here, please feel free to contact us.

How can I find a Hospice organization near me?

Look it up on the National Hospice and Paliative Care Organization's website. They have database of Hospices and other similar organizations which you can search by location. Follow the link below to be taken straight to the search page. Also try looking in your local yellow pages under "hospice".

Find a hospice near you.

When should I call Hospice of Hillsdale County?

The appropriate time to call Hospice of Hillsdale County is when the disease process has advanced to the point that there is a life expectancy of six months or less if the disease runs its expected course.If you aren't sure, please contact us and we'll call your doctor for a determination.

How do I access your services?

Referrals are accepted from patients, families, physicians, social workers and loved ones. If the referral originates from a source other than a physician, Hospice of Hillsdale County will contact the patient's physician to ensure that he/she feels that the patient is hospice appropriate. In addition, all patients are evaluated for hospice appropriateness prior to admission by a registered nurse/social worker. If they feel that other services may be more appropriate, a referral will be made at that time.

How much is this going to cost me?

Hospice services are a Medicare benefit. Hospice of Hillsdale County accepts your insurance payment as payment IN FULL. We will not bill the patient or family for services provided over and beyond the insurance payment.

How long will my loved one live?

The honest answer is that no one knows. Each person is an individual and the end stage disease process differs from individual to individual. The Hospice of Hillsdale County nurse can let you know what to expect. This would include reviewing with you the signs and symptoms of impending death, providing emotional support and offering to stay with you when the time draws near.

Can I keep my own doctor?

Yes. Hospice of Hillsdale County encourages patients and families to continue their physician/patient relationships even when the physician is out of area. In the rare event that the patient has no physician, our Medical Director will be asked to serve as the patient's personal physician.

Why won't he/she eat?

This is one of the most emotionally difficult things a declining patient's family encounters. Patients toward the end of life frequently loose their desire for food. This is caused by the disease process itself as well as the loss of the body's ability to process food. Hospice of Hillsdale County nursing staff will teach the family/loved ones how to keep the patient comfortable and provide nutritional supplements.

Will my loved one have a death rattle?

There are now medications available, in most cases, to prevent terminal congestion. Your hospice nurse will work closely with your physician to obtain the medication necessary to avoid this from occurring.

How often will the nurse come?

The frequency of the nursing visits is dependant upon many factors. A plan of care, including frequency of nursing visits is discussed and agreed upon with the nurse at the time of admission. A minimum visit of once every two weeks is the national requirement. The frequency of nursing visits increase as the patient's condition declines unless the patient/family request otherwise.

When is the nurse available?

Nurses at Hospice of Hillsdale County normally provide routine visits Monday through Friday during regular business hours. In addition, there are two nurses on-call at all times. The patient/family will have direct contact with the on-call nurse through her cell phone.

In the event of a pain or symptom management crisis, the nursing staff will provide continuous care until the crisis is resolved.

What does the nurse do?

Each patient is assigned a primary nurse. Time allowing, the Hospice of Hillsdale County nurse will develop a 1:1 relationship with both the patient and the family. This facilitates trust and confidence. In addition, the nurse can answer questions, actively listen to your feelings and fears, communicate and advocate your needs with your physician, deliver medications, coordinate care, provide instruction and teaching on medications, energy conservation, personal care and the disease process. Your hospice nurse can facilitate life review as well as provide emotional and spiritual support. The nurse can give a bath, give a backrub, change a dressing and hold a hand and hold you when you cry.

When do I call the nurse?

The nurses would appreciate being called whenever there is a change, if there is an increase in pain or other symptoms, if there are any questions, before you call 911 and when you believe the patient is dying or has died. In other words, if in doubt, call.

How will my pain be managed?

The definition of pain is whatever the patient says it is. Some of our patients deny experiencing any pain. Whatever your personal experience may be, Hospice of Hillsdale County nursing staff will work with your physician to establish and maintain the level of comfort you desire.

The WHO (world health organization) Analgesic ladder is utilized. In addition, Hospice of Hillsdale County nursing staff have additional education related to pain and symptom management.

Do I have to have morphine?

No. There are currently other medications available that can control your pain at a level acceptable to you. The decision on which medication and at what dosage will be decided between you and your physician. When you become unable to visit your physician, your hospice nurse will communicate with him/her to ensure that you remain comfortable.

Physical Reactions
  • Deep sighing
  • Rapid heartbeat
  • Increased blood pressure
  • Weakness and fatigue
  • Muscular tension
  • Decreased resistance to illness
  • Sleep disturbances
  • Weight and appetite change
Behavioral Reactions
  • Detached from surroundings
  • Disoriented to time and place
  • Lack of concentration
  • Blameful of others
  • Change in decision making abilities
  • Seeking solitude
  • Apathetic - preoccupied
  • Increase or decrease in activity
  • Finishing "unfinished business"
  • Seeking and providing forgiveness
Emotional Reactions
  • Numbness
  • Confusion
  • Sadness
  • Yearning
  • Anger, guilt
  • Euphoria
  • Feeling of being lost
  • Bitterness - vengefulness
  • Peacefulness

How can I help myself if I am grieving?

Find Support: You need warmth and caring throughout. Friends and relatives can help. Let them.

Accept Your Grief: It is a natural healing process. Roll with its tides.

Look for Models: Grief is painful. It helps to know that others have coped with it. Books and support groups can help.

Learn About Grief: Understanding grief can make it safer and more predictable. It gives hope.

Express It: Without release, grief can leave you frozen and stoic. Journal writing, poetry, drawing, physical activity, music, as well as talking, are ways to let it out. You may need to do it again and again ... and again.

Accept Your Feeling: They may be very intense. Looking at them can help you learn about yourself and the meaning of your loss.

Pace Yourself: Grief takes energy. A slower pace with times of diversion and mild exercise will aid the healing process. Be sure to eat properly.

Trust Yourself: Friend's advice often helps, but you know your needs best.

Don't be Afraid to Have Fun: Laughter is good medicine. Children and pets can help. SMILE.

Maintain Hope: Faith is not the absence of fear, but the willingness to go on when fear is present. Healing will come eventually.

How can I help others who are grieving?

Be There: People in grief need support and presence much more than advice. Be available.

Initiate Contact: The person often wants help, but can't ask.

Listen: Listening without judgement or interruption can be the most important gift you can give.

Touch: It can be healing. Pay attention to the other person's comfort. A hand on the shoulder, a hug, or a neck rub feels good.

Silence is Golden: Sometimes there are no words for grief and no words to take away the pain. Silence can show your trust and acceptance.

Be Patient: With yourself and with your friend. You may need to give more of yourself than you ever imagined.

Have Fun: Laughter and diversion are wonderful ways to regain energy.

Help Your Friend Find Support: Assist them in expanding their support group. Call your local Hospice office, church or other friends for resources.

Be Yourself: Show your feelings and your natural concerns. Be a friend who shares.

Believe In the Person's Ability to Recover and Grow: Your hope and faith may be needed when their's fails.

"I follow rest, rest fled and soon forsook me; I ran from grief, grief ran and overtook me."
Quaies, Emblems, 1635

Is hospice only for cancer patients?

No, hospice care is available for any patient with a physician certified terminal disease and a prognosis of 6 months or less, i.e., heart disease, kidney disease, or end stage Alzheimer's.

Is hospice only available for the elderly?

We care for all ages, though the majority of our patients are 65 and over.

Do I need a primary caregiver before I'm eligible for hospice?

No. Some of our patients are living alone and independent. At the point that a hospice patient needs more care, we work with their family and community organizations/facilities to provide additional assistance as well as increasing our visits and involvement.

Can my family doctor continue to be my doctor when I become a hospice patient?

Yes. You keep the doctor of your choice, providing that physician agrees to follow you during hospice care. If you have an out-of-state physician, Dr. Kimball will co-manage with your physician since an out-of-state doctor can't write orders for narcotics.

Do patients have to be bedridden to be eligible for hospice care?

No. In fact independence is encouraged. Hospice patients don't have to be homebound, they can get out as often and they feel like it.

Will the cost of hospice care deplete my life savings?

Hospce care is reimbursed primarily by insurance companies: Medicare, Medicaid, BX-BS, and private plans. Insurance companies pay hospice a set daily rate for each day a patient recives hospice services. All the expenses for team visits, supplies, equipment, and medications controlling symptoms of the terminal disease are taken out of that daily payment. Daily payment range $120/day, but our program accepts what insurance companies pay us so no billing to patients/families are ever made. We also accept patients without inssurance coverage.