A University of Alabama Law School Clinical Program funded in part by West Alabama Regional Commission

Hospice Care

Hospice care is provided under Part A. No prior hospitalization is necessary. If a patient chooses this option, a doctor must certify that to the best of his or her judgment, the patient is likely to live for six months or less if the illness runs its normal course. However, if the patient survives past that point, hospice is not discontinued, but is re-authorized in 90-day increments. A few patients do survive much longer than expected. Should a hospice patient survive for a year or so, under circumstances in which the physician cannot reasonably certify that death is likely within six months, hospice care would be discontinued until and unless the situation again appears terminal and the patient again elects that option. In any case, if hospice is chosen, the focus of treatment changes from seeking a cure that is no longer realistic, to providing comfort and support. As palliative care workers sometimes say, "caring, not curing".

Hospice pays for everything, including oxygen, most drugs, hospital bed if needed, at no extra charge. There may be a small copayment for some medications. A registered nurse, social worker, aide if needed, and minister are part of the care team, providing medical care and psychological support at difficult times. This is not around-the-clock care, however. If hospice care is provided at home and 24-7 care is needed, there must be a family member or friend to provide it. Both patients and caregivers welcome the assurance of knowing that skilled help is on call, and a major benefit is the ready availability of adequate pain relief.

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