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The appropriate time to call Hospice of Hillsdale County is when the disease process has advanced to the point that there is a life expectancy of six months or less if the disease runs its expected course. If you aren’t sure, please contact us and we’ll call your doctor for a determination.

Referrals are accepted from patients, families, physicians, social workers, and loved ones. If the referral originates from a source other than a physician, Hospice of Hillsdale County will contact the patient’s physician to ensure that he/she feels that the patient is hospice-appropriate.

Hospice services are a Medicare benefit. Hospice of Hillsdale County accepts your insurance payment as payment IN FULL. We will not bill the patient or family for services provided over and beyond the insurance payment.

The honest answer is that no one knows. Each person is an individual and the end-stage disease process differs from individual to individual. The Hospice of Hillsdale County nurse can let you know what to expect. This would include reviewing with you the signs and symptoms of impending death and providing emotional support when the time draws near.

Yes. Hospice of Hillsdale County encourages patients and families to continue their physician/patient relationships even when the physician is out of the area. In the event that the patient has no physician, our Medical Director will be asked to serve as the patient’s personal physician.

The frequency of the nursing visits is dependant upon many factors. A plan of care, including frequency of nursing visits, is discussed and agreed upon with the nurse at the time of admission. A minimum visit of once every two weeks is the national requirement. The frequency of nursing visits increases as the patient’s condition declines unless the patient/family request otherwise.

Nurses at Hospice of Hillsdale County normally provide routine visits Monday through Friday during regular business hours. In addition, there are two nurses on-call at all times. The patient/family will have direct contact with the on-call nurse through their cell phone. In the event of a pain or symptom management crisis, the nursing staff will provide continuous care until the crisis is resolved.

Each patient is assigned a primary nurse. Time allowing, the Hospice of Hillsdale County nurse will develop a 1:1 relationship with both the patient and the family. This facilitates trust and confidence. In addition, the nurse can answer questions, actively listen to your feelings and fears, communicate and advocate your needs with your physician, coordinate care, provide instruction and teaching on medications, energy conservation, personal care, and the disease process. Your hospice nurse can facilitate life review as well as provide emotional and spiritual support.

The nurses would appreciate being called whenever there is a change if there is an increase in pain or other symptoms, or if there are any questions before you call 911, and when you believe the patient is dying or has died. In other words, if in doubt, call.

The definition of pain is whatever the patient says it is. Some of our patients deny experiencing any pain. Whatever your personal experience may be, Hospice of Hillsdale County nursing staff will work with your physician to establish and maintain the level of comfort you desire.

The WHO (world health organization) Analgesic ladder is utilized. In addition, Hospice of Hillsdale County nursing staff has additional education related to pain and symptom management.

No. There are currently other medications available that can control your pain at a level acceptable to you. The decision on which medication and at what dosage will be decided between you and your physician. When you become unable to visit your physician, your hospice nurse will communicate with him/her to ensure that you remain comfortable.

No, hospice care is available for any patient with a physician-certified terminal disease and a prognosis of 6 months or less, this includes, but is not limited to diagnoses such as heart disease, kidney disease, or end-stage Alzheimer’s.

We care for all ages, though the majority of our patients are 65 and over.

No. Some of our patients are living alone and independently. At the point that a hospice patient needs more care, we work with their family and community organizations/facilities to provide additional assistance as well as increasing our visits and involvement.

Yes. You keep the doctor of your choice, providing that physician agrees to follow you during hospice care. If you have an out-of-state physician, Dr. Kimball will co-manage with your physician since an out-of-state doctor can’t write orders for narcotics.

No. In fact, independence is encouraged. Hospice patients don’t have to be homebound, they can get out as often and they feel like it.

Hospice care is reimbursed primarily by insurance companies: Medicare, Medicaid, BX-BS, and private plans. All the expenses for team visits, supplies, equipment, and medications controlling symptoms of the terminal disease are taken out of that payment. Our program accepts insurance reimbursement as payment in full. No billing to patients/families is ever made. We also accept patients without insurance coverage.