This month -- National Hospice & Palliative Care Month -- is a time to remember that hospice is not a place, but is high-quality care.

Hospice, which debuted in the United States in 1974, focuses on caring, not curing, and is growing in popularity for people facing a life-limiting illness.

Since its inception, hospice care has grown to about 4,500 Medicare-certified programs, according to the National Hospice and Palliative Care Organization.

The organization said hospice is considered the model for “quality compassionate care.” That care includes medical treatment, pain management and emotional and spiritual support tailored to a patient’s needs and desires.

Care is usually given in the patient’s home, but it might also be provided in a freestanding hospice, hospitals, nursing homes and other long-term care facilities. Hospice services are available to patients with any terminal illness or at any age.

More than one million people in the United States have died in hospice care, which represents about 42 percent of all deaths, the National Hospice and Palliative Care Organization said.

The Hospice Foundation of America defines hospice as “a special concept of care that provides comfort and support to patients and their families when a person has a terminal illness or disease that is no longer responding to curative care and who has been given a prognosis of about six months of life.”

A team of skilled professionals and volunteers, often called the interdisciplinary team, works with the patient to address all symptoms of a disease, the foundation said.

Usually, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill patient. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. The hospice staff is on-call 24 hours a day, seven days a week.

With several hospices serving some communities, it can seem challenging to select one.

The hospice and palliative care organization said the best way to begin the selection is by contacting hospice providers in your community to find the one best suited to meet your specific needs.

“Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” J. Donald Schumacher, the organization’s president and CEO, said in a release.

“Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”

Some of the questions to ask in choosing a hospice might include:

Is the hospice Medicare certified?

When was the last state or federal survey of the program?

What services should I expect from the hospice?

How are services provided after hours?

How and where does hospice provide short-term inpatient care?

What services do volunteers offer?

How long does it typically take the hospice to enroll someone once the request for services is made?

What expectations will the hospice have from the patient and the patient’s support system.

What kind of support and training program does the hospice have for caregivers.

Another question often asked is when to begin hospice care.

Every patient and family must decide that based on their needs. However, professionals encourage people to learn about care options long before they think they may need them.

A referral is required and might be acquired through the attending physician or by contacting a hospice directly.

Hospice care is available for people with a wide range of illnesses, including cancer, endstage Alzheimer’s disease and end-stage renal disease.

Specific guidelines for many illnesses, including advanced dementia, have been developed by hospices.

To be eligible for hospice, patients have to show deterioration in their overall condition with some functional decline (such as needing more assistance with daily activities than in the recent past).

Hospice patients may continue any activities they enjoy and are able to do, including going to community events, driving and being involved in activities with their families and friends.

A hospice patient can leave hospice care at any time. Hospice care is all about choice. This means that patients and their loved ones can choose which hospice provides care, where they receive hospice care and if they wish to continue or discontinue hospice services. If a hospice patient decides to pursue curative treatment, he may discontinue hospice services and get other treatment. And, if the patient wants to re-enter hospice care at a later date, he may do so.

Hospice care is covered by Medicare. You can get Medicare hospice benefits when you meet all of the following conditions:

You are eligible for Medicare Part A (hospital insurance).

Your doctor and the hospice medical director certify that you are terminally ill and have 6 months or less to live if your illness runs it normal course.

You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness. (Medicare will still pay for covered benefits for any health problems that aren’t related to your terminal illness, such as an injury.)

You receive care from a Medicare-approved hospice program.

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