Kimberlie Miller, LCSW
MDMH's Hospice Social Worker
1200 Westwood Drive Hamilton, MT 59840
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.