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Understanding Hospice Care
Is it time for your loved one to start their hospice journey? Pebbles Thornton, RN, MSN, OCN shares what you need to know to make the best decision for you and your family.
Featuring:
Pebbles Thornton, RN, MSN, OCN
Pebbles Thornton, RN, MSN, OCN, Director of Cancer, Palliative Medicine and Hospice Services at Genesis HealthCare System, has 4 years of experience as the director of Genesis Hospice and 13 years of experience as a registered nurse. Transcription:
Scott Webb: When we or a friend or loved one has to consider hospice or end-of-life care, we likely have more questions than answers. I'm joined today by someone who has those answers for us. Pebbles Thornton is a registered nurse and Director of Cancer Services, Palliative Medicine and Hospice Care with Genesis.
This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare. I'm Scott Webb. So Pebbles, thanks so much for joining me today. We're going to talk about hospice care and what that means. And, you know, I've had relatives and neighbors and things, you know, go into hospice care, but I'm not a hundred percent sure I know what that means, and maybe listeners have some questions as well. So, it's great to have your expertise. So, let's just start here, what is hospice?
Pebbles Thornton: So, hospice is a type of healthcare that's delivered at the end of life. So when someone is certified as terminally ill, which usually means that they on paper have six months or less to live, they would be eligible to enroll in hospice care where we then start to focus on symptoms, emotional, spiritual needs, making sure that their quality of life is as good as it possibly can be, so they can spend that important time with their family.
Scott Webb: Yeah, it is important time, of course. And let's talk about who's eligible and maybe also who's making these decisions. Is it oftentimes the patient themselves or is it family members or sort of collective decisions? How does that work?
Pebbles Thornton: That's a great question. So, anyone can refer to hospice, including yourself or your family member can refer to hospice. However, we do need to have a physician who is willing to certify that, based on your diagnosis, the typical journey would be six months or less. No one has, you know, an expiration date stamped on the bottom of their foot. But we do have to have a physician who certifies that, in normal circumstances, your life expectancy is six months or less. But if you're interested in learning about hospice care, you don't have to have a physician do that. You can make that referral yourself.
Scott Webb: I see. Okay. Good to know. And so, what are some of the things that someone should consider if they're trying to decide whether or not to choose hospice care or a particular hospice provider?
Pebbles Thornton: The Centers for Medicare and Medicaid Services, also called CMS, has an amazing website, that is compare.gov, so C-O-M-P-A-R-E.gov. And when you go there, you can put in your ZIP code and then it will list all of the available hospices in your area, and then it'll also show some specific things that you really need to look for.
The first thing that I would start with is this a for-profit hospice or is this a not-for-profit hospice? There are differences in those and the way that they run their business is very much different if it's a not-for-profit versus a for-profit.
The next thing I would look at is how long have they been in business. Is it someone that's been established in the community for a long time? Or is it someone who just started their company up? Is it a company who's local or is it someone who is a national company?
The last thing that I would look at is does that hospice have its own inpatient unit. We always want to provide hospice care in someone's home regardless of what that definition of home is, so if it's, you know, their actual home or a facility or what have you. But we can bring people into our inpatient unit for symptom management, and not every hospice has an inpatient unit for that. Many of them will contract with local facilities to have that service available because they're required for it, but it's not hospice-dedicated staff that's caring for that person. So if I'm looking at who's going to be covering for my loved one, I want someone who's trained to care for them.
Scott Webb: Yeah. That just seems like just great advice and good common sense, especially if, you know, we're in a position where we're thinking about having to put a relative into hospice care and all that that implies. Definitely some questions to ask, some boxes to check. And let's talk a little bit about Genesis Hospice. What kinds of hospice services are available at Genesis?
Pebbles Thornton: Absolutely. Hospice is comprehensive care. You can, like I said before, receive your care anywhere that you call home. And that includes, you know, your own home, a family member's home, a nursing home, or an assisted living residence. And your hospice team works with you to come up with your individualized care plan.
So, what does that mean? Does that mean that I need to have an aide come in three times a week to help me with, you know, my care? Or does that mean I need to have a nurse come a couple times a week? We are required to see patients at least once every 14 days. But you can imagine that everyone's care plan looks a little different. Some people need more help, others don't. But that care team consists of nurses, aids, chaplains, social workers, music therapy. We have a large team that helps count on giving good care to their patients.
Scott Webb: Yeah. So, it sounds like it's pretty comprehensive, sort of multidisciplinary in a way. And unfortunately, Pebbles, a lot of times we have these conversations, it always seems to come back to insurance one way or another. So, what if someone's insurance doesn't pay for all the costs of hospice at Genesis?
Pebbles Thornton: So, we first of all do not turn anyone away, regardless if you have insurance or not. At Genesis Hospice, we will care for you, whether your insurance covers or not. That being said, most insurances will cover hospice benefits at a hundred percent. However, there are a few, especially those commercial insurances that may not cover it a hundred percent. But that's why we have such an amazing community who donates money to help cover for those items that may not be covered by insurance. And so, we never want anyone to be stuck with an out-of-pocket cost that they cannot afford. So, we would work directly with that person and come up with an option for them.
Scott Webb: Yeah. Amazing, for sure. And, it's been really educational as I sort of prefaced when we got rolling here. It's like I sort of know what hospice is, but great to have your expertise and answer these questions today. And you gave us the resource earlier, the website, on how to just find the hospice providers in a respective area. But maybe you can take us through, when we think about comparing, right? So, we see a list of these things. How should we compare local hospice providers when we're trying to choose one?
Pebbles Thornton: Yeah. So, that's where I'm going to direct you back to that Medicare website, compare.gov, because you can click box like three different hospices and it will put it right up on the screen for you to compare those three hospices side by side. And you know that it's based on information that is given to the government, so it should be accurate. And that's really your best place to go look for a quality hospice provider is going to be.
If anyone is interested in volunteering to come, we rely heavily on our volunteer services to help keep our hospice program going. And if you're somebody who likes to come help us with our gardens or the bird feeders, or you prefer more one-on-one patient care or you want to just come sit with someone and chat with them for an hour because they're lonely, we have a job for you. So if you're interested, please feel free to reach out to us and we can get you hooked up with our volunteer coordinator and have you as part of our team as well.
Scott Webb: Yeah, that's really helpful. As we all know, these end-of-life decisions can be really stressful. And so, anything we can do to try to make it easier for us, if we're the ones making those decisions and finding the right place for a, you know, cherished loved one, family member, mom, dad, grandma, grandpa, whomever it is, certainly welcome. So Pebbles, thanks so much for your time today. You stay well.
Pebbles Thornton: Thank you.
Scott Webb: And visit genesis.org/hospice to learn more. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.
Scott Webb: When we or a friend or loved one has to consider hospice or end-of-life care, we likely have more questions than answers. I'm joined today by someone who has those answers for us. Pebbles Thornton is a registered nurse and Director of Cancer Services, Palliative Medicine and Hospice Care with Genesis.
This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare. I'm Scott Webb. So Pebbles, thanks so much for joining me today. We're going to talk about hospice care and what that means. And, you know, I've had relatives and neighbors and things, you know, go into hospice care, but I'm not a hundred percent sure I know what that means, and maybe listeners have some questions as well. So, it's great to have your expertise. So, let's just start here, what is hospice?
Pebbles Thornton: So, hospice is a type of healthcare that's delivered at the end of life. So when someone is certified as terminally ill, which usually means that they on paper have six months or less to live, they would be eligible to enroll in hospice care where we then start to focus on symptoms, emotional, spiritual needs, making sure that their quality of life is as good as it possibly can be, so they can spend that important time with their family.
Scott Webb: Yeah, it is important time, of course. And let's talk about who's eligible and maybe also who's making these decisions. Is it oftentimes the patient themselves or is it family members or sort of collective decisions? How does that work?
Pebbles Thornton: That's a great question. So, anyone can refer to hospice, including yourself or your family member can refer to hospice. However, we do need to have a physician who is willing to certify that, based on your diagnosis, the typical journey would be six months or less. No one has, you know, an expiration date stamped on the bottom of their foot. But we do have to have a physician who certifies that, in normal circumstances, your life expectancy is six months or less. But if you're interested in learning about hospice care, you don't have to have a physician do that. You can make that referral yourself.
Scott Webb: I see. Okay. Good to know. And so, what are some of the things that someone should consider if they're trying to decide whether or not to choose hospice care or a particular hospice provider?
Pebbles Thornton: The Centers for Medicare and Medicaid Services, also called CMS, has an amazing website, that is compare.gov, so C-O-M-P-A-R-E.gov. And when you go there, you can put in your ZIP code and then it will list all of the available hospices in your area, and then it'll also show some specific things that you really need to look for.
The first thing that I would start with is this a for-profit hospice or is this a not-for-profit hospice? There are differences in those and the way that they run their business is very much different if it's a not-for-profit versus a for-profit.
The next thing I would look at is how long have they been in business. Is it someone that's been established in the community for a long time? Or is it someone who just started their company up? Is it a company who's local or is it someone who is a national company?
The last thing that I would look at is does that hospice have its own inpatient unit. We always want to provide hospice care in someone's home regardless of what that definition of home is, so if it's, you know, their actual home or a facility or what have you. But we can bring people into our inpatient unit for symptom management, and not every hospice has an inpatient unit for that. Many of them will contract with local facilities to have that service available because they're required for it, but it's not hospice-dedicated staff that's caring for that person. So if I'm looking at who's going to be covering for my loved one, I want someone who's trained to care for them.
Scott Webb: Yeah. That just seems like just great advice and good common sense, especially if, you know, we're in a position where we're thinking about having to put a relative into hospice care and all that that implies. Definitely some questions to ask, some boxes to check. And let's talk a little bit about Genesis Hospice. What kinds of hospice services are available at Genesis?
Pebbles Thornton: Absolutely. Hospice is comprehensive care. You can, like I said before, receive your care anywhere that you call home. And that includes, you know, your own home, a family member's home, a nursing home, or an assisted living residence. And your hospice team works with you to come up with your individualized care plan.
So, what does that mean? Does that mean that I need to have an aide come in three times a week to help me with, you know, my care? Or does that mean I need to have a nurse come a couple times a week? We are required to see patients at least once every 14 days. But you can imagine that everyone's care plan looks a little different. Some people need more help, others don't. But that care team consists of nurses, aids, chaplains, social workers, music therapy. We have a large team that helps count on giving good care to their patients.
Scott Webb: Yeah. So, it sounds like it's pretty comprehensive, sort of multidisciplinary in a way. And unfortunately, Pebbles, a lot of times we have these conversations, it always seems to come back to insurance one way or another. So, what if someone's insurance doesn't pay for all the costs of hospice at Genesis?
Pebbles Thornton: So, we first of all do not turn anyone away, regardless if you have insurance or not. At Genesis Hospice, we will care for you, whether your insurance covers or not. That being said, most insurances will cover hospice benefits at a hundred percent. However, there are a few, especially those commercial insurances that may not cover it a hundred percent. But that's why we have such an amazing community who donates money to help cover for those items that may not be covered by insurance. And so, we never want anyone to be stuck with an out-of-pocket cost that they cannot afford. So, we would work directly with that person and come up with an option for them.
Scott Webb: Yeah. Amazing, for sure. And, it's been really educational as I sort of prefaced when we got rolling here. It's like I sort of know what hospice is, but great to have your expertise and answer these questions today. And you gave us the resource earlier, the website, on how to just find the hospice providers in a respective area. But maybe you can take us through, when we think about comparing, right? So, we see a list of these things. How should we compare local hospice providers when we're trying to choose one?
Pebbles Thornton: Yeah. So, that's where I'm going to direct you back to that Medicare website, compare.gov, because you can click box like three different hospices and it will put it right up on the screen for you to compare those three hospices side by side. And you know that it's based on information that is given to the government, so it should be accurate. And that's really your best place to go look for a quality hospice provider is going to be.
If anyone is interested in volunteering to come, we rely heavily on our volunteer services to help keep our hospice program going. And if you're somebody who likes to come help us with our gardens or the bird feeders, or you prefer more one-on-one patient care or you want to just come sit with someone and chat with them for an hour because they're lonely, we have a job for you. So if you're interested, please feel free to reach out to us and we can get you hooked up with our volunteer coordinator and have you as part of our team as well.
Scott Webb: Yeah, that's really helpful. As we all know, these end-of-life decisions can be really stressful. And so, anything we can do to try to make it easier for us, if we're the ones making those decisions and finding the right place for a, you know, cherished loved one, family member, mom, dad, grandma, grandpa, whomever it is, certainly welcome. So Pebbles, thanks so much for your time today. You stay well.
Pebbles Thornton: Thank you.
Scott Webb: And visit genesis.org/hospice to learn more. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.