Kimberlie Miller, LCSW
MDMH's Hospice Social Worker
1200 Westwood Drive Hamilton, MT 59840
(406) 363-6503

Hospice is a program offered under Medicare/ Medicaid and most private insurance programs designed for end of life comfort care. The goal of hospice is not to cure a terminal illness, nor to prolong life or hasten death; the goal is to alleviate pain, discomfort and suffering. Hospice services are accessed through a physician referral; the physician attests that in their opinion, the patient is suffering from a terminal condition which will end their life in six months or less (there are a number of specific diagnoses which meet these criteria). The Hospice Medicare/Medicaid Benefit covers the following services 100% when they are related to the primary terminal illness and included in the Hospice Plan of Care which is developed collaboratively with the hospice program care team and the patient's primary care physician.

Physician services - if the patient needs to attend scheduled visits for specific reasons with their primary care physician, those visits are covered by Medicare/Medicaid. Private insurance benefits can vary. The goal of hospice, however, is to decrease regular physician visits so that the patient can remain at home and receive the bulk of their care from the hospice care team.

Hospice provides for regularly scheduled Registered Nursing visits, as well as 24 hour access to Registered Nurse on-call after hours, and on weekends. This on-call availability eliminates the need for emergency department visits for after hour crises which may include an array of pain and symptom management issues which can occur with a terminal illness. The goal of a hospice program is to eliminate the need the for seeking emergency services through an emergency department; in fact, Medicare may not cover services outside of the Hospice Plan of Care and so specific life prolonging or curative measures need to be addressed with the patients physician and identified/included under the hospice Plan of Care in order for Medicare/Medicaid to provide payment/coverage.

Home Health aide for in home personal hygiene care 1-2 times per week is another important benefit under Hospice services. Adding the skills of a professional health aide to provide regular, safe bathing and hygiene care allows for hospice patients to continue feeling clean and fresh with dignity and respect. A home health aide can free up family members from this additional task that can become challenging and emotionally charged. Caregivers consistently praise MDMH Hospice Care Team for the addition of our bath aide because she provides professional skilled care as well as education for family and linkage back to the Hospice Care Team with important information about skin condition, emotional and physical changes for the patient, and challenges that may arise for primary caregivers.

Social Work and Chaplain Services are also included for patients and their families to cover emotional, spiritual, and resource linkage needs.



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