Dr. Robert Webb The primary goal of hospice is to prevent suffering and help someone with a terminal disease live comfortably as long as possible. Home Health’s [HH] is to maintain or improve physical function (daily activities such as toileting, dressing, walking) in someone not at the end of life. Both services are covered by Medicare/ insurers for limited periods of time but a physician must certify that the service is necessary.

For staffing, both services have nurses reporting on the patient’s condition to the attending doctor; and also offer help with bathing, dressing, etc., with frequency of visits ranging from daily to weekly. Social workers are used more often when hospice is involved.

The hospice’s medical director reviews the medications and general status at least every two weeks (during team meetings); whereas the HH sends reports to the patient’s doctor. Some hospice medical directors [such as ours] make house calls, which helps improve care.

256-767-6699 Hospice agencies have a chaplain—someone trained in endof life issues/discussions—and bereavement counselor to support families for a minimum of 13 months following the death; as well as volunteers to sit with patients, or run errands for the family.

Hospices pay for medications needed for comfort [often limited to their own formulary of drugs to control pain, shortness of breath, nausea, etc.]; non-comfort drugs [such as for lowering cholesterol] are not usually covered. A few hospices may cover short-term palliative cancer chemotherapy or radiotherapy [usually to control pain]. Home Health rarely covers medications.

There is no cost for any hospice service/equipment – such as a hospital bed, oxygen, or commode chair—whereas HH usually has deductibles and co-pays.

Ask Dr. Webb is a bi-weekly article sponsored by Hospice of the Shoals as a community service to answer questions about hospice care and end of life issues. Please submit questions to ssimpson@hofts.org or call 256-767-6699. Dr. Robert Webb has focused his practice on geriatrics and palliative care since 2003. He is the Medical Director at Glenwood Healthcare as well as the Medical Director at Hospice of the Shoals.