Most services are provided in the home, but services can also be at a skilled nursing facility, residential care home, or in our Hospice House. Hospice services are available to patients of any age, religion, race, or terminal illness. All chronic illnesses that become life-limited, as described in the diagnostic tools tab, qualify for our services.
Hospice services are covered under the Medicare and Medi-Cal hospice benefit, and partially covered by some private insurance plans, HMOs, and other managed care organizations. This means that under the benefit we provide services, medications, and necessary durable medical equipment related to the terminal diagnosis. Continued therapies such as blood transfusions, IV hydration, and artificial nutrition through feeding tubes, chemotherapy, Procrit injections or physical therapy generally are not considered “comfort” care as defined by the benefit.
Hospice provides services through a “team-oriented” approach to medical care—the interdisciplinary team—to provide pain management, symptom management, and emotional and spiritual support that is patient-specific. A plan of care is developed to address the patient’s unique problems and to prevent unnecessary hospitalizations. The team consists of:
- The patient’s personal physician
- The Hospice physician (or medical director)
- Registered Nurses
- Licensed Vocational Nurses
- Home Health Aides
- Social Workers
- Trained Volunteers
Among its major responsibilities, the team: manages the pain and symptoms; assists the patient and family with emotional, psychosocial and spiritual aspects of dying; provides ongoing teaching regarding patient care; provides needed drugs, medical supplies and equipment; and provides bereavement care and counseling to surviving family. Through practical day-to-day support from the team, the patient can live comfortably and enjoy being at home with family and friends.
The process begins when you consider hospice care for your patients. You may find the diagnostic tools tab beneficial in determining patient admission criteria. Should your patients meet the admission criteria Hospice of San Joaquin will need a complete referral fax form.
To Make a Referral:
Please complete the referral fax form as you, the physician is certifying the patient has a terminal illness, and prognosis is 6 months or less if the disease runs its natural course. A registered nurse and a social worker will then visit the patient and family and do initial assessments and have legal documents signed. It is essential the patient has a caregiver to administer medications and provide patient care, and that the home environment is safe. For this reason, all admissions to hospice care are done in the home, generally within 24 hours of receipt of referral. We are, however, available to see patients and families in the hospital setting prior to admission and to provide information as needed.
When cure is no longer possible and treatments become futile, consider comfort care.
The single greatest barrier to referral to hospice services is not discussing the goals of care as your patient’s terminal disease progresses; and, prognostic information is often the single most important piece of information that patients need to make informed choices.