Joseph Shega, MD / Executive VP & Chief Medical Officer VITAS® Healthcare

A: Most Americans would prefer to die at home if given a choice. Yet, according to a Kaiser Family Foundation survey, expectations of actually doing so fall short. About half of those surveyed (49%) believe most people have too little control over decisions about their own medical care at the end of life. Of those who rated their own health as fair or poor, that figure rises to 69%.

Yet only 1 in 10 have discussed their wishes for care near the end of life with a healthcare professional. Initiating this conversation is a powerful step you can take to help ensure that the care you receive in the future is in line with your values, goals, and preferences. These conversations should continue, change, and evolve, depending on how your health changes in the future. 

Hospice care, where the focus is on comfort and quality of life vs. aggressive curative treatments, is the preferred choice for many. A six-month, earned benefit, the Medicare Hospice Benefit is inclusive: all services related to the advanced illness are covered up to 100% percent by Medicare Part A. Coverage includes visits, as well as medications, equipment, and supplies.

Almost 95% of all hospice care takes place in patients’ homes. While there is no limit to the time a patient can receive hospice services, the benefit is for patients who have six months or less to live according to a doctor, and it can be extended when needed. Family members often say, “we wish we had known about hospice sooner.”

While all hospice providers are reimbursed the same way, services vary by provider. At VITAS® Healthcare, our unique care model includes services that go beyond the requirements of the Medicare Hospice Benefit. For over 40 years, we have been guided by a core value: “Patients and families come first.” Every VITAS service is designed to surround patients, their families, and caregivers with support that elevates quality of life, manages their symptoms and pain, and ensures comfort and dignity during one of life’s most difficult—but meaningful—periods.

With clinical care guided by our full-time medical directors, VITAS also provides 24/7/365 support by phone and by-the-bedside support when emergencies arise. Our inclusive approach to the hospice plan of care includes the primary care physician and continues patients’ medications to control symptoms. Bereavement support is also integral to the VITAS care model, with specialists providing support to loved ones for at least 13 months following a death.