Is hospice for cancer patients only?
Hospice care is provided for all “end-stage” diseases. End-stage refers to any disease that has progressed to a point where the patient is given a prognosis of 6 months or less to live by their doctor. Hospice care can continue past six months if the patient lives longer.

How are patients referred to Gateway Hospice?
Normally, the patient’s doctor makes the prognosis, that the patient has less than six months to live, and refers the family to hospice. If a patient or family feels hospice is appropriate, they can also contact us directly and we will consult with their doctor. We have long-standing relationships with many of the physicians in our service area.

When should a decision about entering a hospice program be made and who should make it? At any time during a life-limiting illness, it's appropriate to discuss all of the patient's care options, including hospice. By law, the decision belongs to the patient. Understandably, most people are uncomfortable with the idea of stopping an all-out effort to recover from their disease. Hospice staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.

Should I wait for our physician to raise the possibility of hospice or should I raise it first? The patient and family should feel free to discuss hospice care at any time with their physician, other healthcare professionals, clergy or friends.

What if our physician doesn’t know about hospice? Most physicians know about hospice. If your physician wants more information, the staff of Gateway Hospice will be happy to answer their questions or provide educational publications. Other good resources are The American Academy of Hospice and Palliative Medicine, medical societies, state hospice organizations, local hospices, or the National Hospice and Palliative Care Organizational Helpline, 1-800-658-8898, or visit their website at www.nho.org. In addition, physicians and all others can obtain information on hospice from the American Cancer Society, the American Association of Retired Persons, and the Social Security Administration.

What is the hospice philosophy towards death? Hospice care affirms life and regards dying as a normal process. It neither hastens nor postpones death, but works to achieve the best quality of life for patients and their families by managing pain and symptoms and by providing emotional and spiritual support as needed and requested.

How is hospice care paid for?
Professional care of the hospice team is provided regardless of ability to pay. In many cases third party insurance reimburses Gateway Hospice for part of the cost of hospice care and Gateway Hospice can accept Medicare, TriCare and TennCare.

If the patient is eligible for Medicare, will there be any additional expense to be paid?
Medicare covers all services and supplies for the hospice patient related to the terminal illness. In some hospices, the patient may be required to pay a 5% or $5 "co-payment" on medication and a 5% co-payment for respite care. You should find out about any co-payment when selecting a hospice. Gateway Hospice does not charge any co-pays for services provided.

Who is involved in the care of the patient? Hospice care involves a team approach to care. The patient’s doctor remains involved, and our nurses, social worker, home health aides, chaplain, and hospice trained volunteers work together to support the patient and family in this time of need.

How often do the team members visit? Gateway Hospice formulates a care plan specific to each patient and his or her needs. The frequency of visits varies according to the patient’s needs. Gateway Hospice nurses are on call for medical advice or emergencies 24 hours a day, 7 days a week. We educate and support the family or other caretakers to be the primary caregivers.

Is the patient always in a home setting? Not necessarily. Though most Americans have indicated that they would prefer to be cared for at home if they were given six months or less to live, Gateway Hospice can also attend patients who reside in participating long-term care facilities.

What areas does Gateway Hospice serve? Gateway Hospice serves Montgomery, Stewart, Houston, Dickson, Cheatham and Robertson counties.

Can a hospice patient who shows signs of recovery be returned to regular medical treatment? If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged from hospice and return to aggressive curative therapy or go on about his or her daily life. If a discharged patient should later need to return to hospice care, Medicare and most private insurance companies will allow additional coverage for this purpose.

What does the hospice admission process involve? Hospice staff will contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. We have medical staff available to help patients who have no physician. The patient will also be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital.The "hospice election form" says that the patient understands that the care is palliative (that is, comfort care aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.

Is there any equipment or special changes I have to make in my home before hospice care begins? Gateway Hospice will assess your needs, recommend any necessary equipment, and help make arrangements to obtain it. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

How many family members or friends does it take to care for a patient at home? Hospice staff will prepare an individualized care plan that will address the amount of caregiving a patient needs. The hospice staff visits regularly and is always accessible to answer questions and provide support.

Must someone be with the patient at all times? In the early weeks of care, it's usually not necessary for someone to be with the patient at all times. Later hospice generally recommends someone be there continuously. This is mostly dependent on the patient’s abilities and safety concerns. While family and friends must be relied on to give most of the care, hospice does provide volunteers to assist with errands and to provide a break and time away for major caregivers.

What specific assistance does hospice provide home based patients? The hospice team includes nurses, a social worker, counselors, home health aides, clergy, and volunteers. In addition, hospices provide medications, supplies, equipment, and hospital services related to the terminal illness.

How difficult is caring for a dying loved one at home? It's never easy and sometimes can be quite emotionally and physically draining. At the end of a long, progressive illness, nights especially can be very long, lonely and scary. Staff is available around the clock to consult with the family and to make night visits as appropriate.

Does hospice do anything to make the death come sooner? Nothing is done to speed up or slow down the dying process. Just as doctors and midwives lend support and expertise during the time of childbirth, hospice provides its presence and specialized knowledge during the dying process.

Does hospice provide any help to the family after the patient dies? Gateway Hospice offers continuing contact and support for family and friends for at least 12 months following the death of a loved one. This is done through mailings, phone calls and personal contacts. Gateway Hospice also holds an annual memorial service to remember the patients that were under our care.

How does hospice “manage pain”? Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish, and they are often joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.