General hospice Information

What’s the difference between hospice and palliative care?
Is hospice provided in the hospital? Or is it a place?
Can my mother keep her doctor?
What do we do in case of an emergency? 

receiving Hospice Care 

How do I get my family member into hospice care?
How do I know I’m ready? How do we know our loved one is ready?
My loved one isn’t dying. How do I know if he’s ready for hospice?

Planning for end of life 

What are Advance Directives?
Do we need a DNR? 

Additional Considerations 

Does hospice speed up the dying process? Will hospice help my mother die?
Does hospice hasten death?
Don’t you give narcotics and sedating medicine to make a hospice patient sleep?
I thought hospice was only for cancer patients?
What if I get better?
Does going on hospice mean this is “the end”?



What’s the difference between hospice and palliative care?
All hospice is palliative care (care at the end of life), but not all palliative care (care to make the patient comfortable), is hospice. Both focus on patient-centered care that relieve suffering, enhance quality of life and is unique to each person’s culture, values and beliefs. Palliative Care is most often provided in hospitals and is offered regardless of stage of disease or need for other therapies. Hospice is generally for people who have advanced illness whose curative-oriented treatment is causing more burden than benefit. Patients usually enroll when their physicians determine that they may have a life expectancy of less than six months if their disease runs its normal course.

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My loved one isn’t dying. How do I know if he’s ready for hospice?
Many hospice patients are very functional—they are walking, talking with their family and friends, and fixing meals. Hospice care is appropriate for patients when they, or their physicians, start to question whether the treatments and hospitalizations are causing more problems and discomfort than improving the person’s sense of well-being.

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Does hospice speed up the dying process? Will hospice help my mother die?
Hospice neither hastens nor prolongs the dying process. The goals of hospice care are to maximize quality of life; ensure that symptoms, whether pain, nausea, or confusion, are well-managed; and suffering is minimized during the later stages of illness.

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Is hospice provided in the hospital? Or is it a place?
Hospice is not a place; it’s a program that is delivered in a patient’s private home or apartment, or in a skilled nursing facility. Hospice may also be provided in a short-term inpatient setting, like the VNSNY Haven Hospice Specialty Care Unit. Some hospices have a residence or group home for people who are unable to remain at home, either because they live alone or their family members can no longer care for them. VNSNY has an eight-bed residence located in upper Manhattan called the Shirley Goodman and Himan Brown Hospice Residence.

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Does hospice hasten death?
Hospice is about living life to its fullest and treating patients with dignity and respect. The hospice team works to help patients feel as well as possible by addressing the emotional and spiritual, as well as the physical needs, of both the patient and family.

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Don’t you give narcotics and sedating medicine to make a hospice patient sleep?
We provide medication that helps to manage pain, and other symptoms, while keeping the patients as alert as possible. Most patients can receive adequate pain control while remaining alert and oriented. Changes in medications are always made in consult with patients and their families.

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Can my mother keep her doctor?
Yes, VNSNY Hospice prefers to work with your current doctor, the professional with whom you already have a relationship. Since many doctors don’t make home visits, our hospice doctors can serve as a backup for your regular doctor.

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I thought hospice was only for cancer patients?
Hospice is available to anyone who has advanced disease, whether cancer, advanced dementia, or other diseases of the heart, lung, liver, kidney or bone.

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What if I get better?
If your health condition improves and you no longer qualify for hospice, we will work with you and your family to transfer you to a more appropriate program.

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Does going on hospice mean this is “the end”?
While nobody truly knows what is going to happen in the future, patients are referred to hospice when their disease is advanced. Our job as a hospice program is to help you live as well as you possibly can and help you enjoy what is most important to you at this time.

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How do I know I’m ready? How do we know our loved one is ready?
Being part of a hospice program prior to getting extremely sick and bed-bound provides more opportunity for enhancing quality of life and promoting effective communication among family members and health care providers. The earlier you come to hospice, the better the opportunity to improve quality of life and communication between you, your family and your doctors, so everybody is aware of what to expect in the future and can make decisions based on that knowledge.

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What are Advance Directives?
An Advance Directive is a type of written or verbal instruction about health care which is to be followed if a person becomes unable to make decisions regarding his or her medical treatment. There are four types of advance directives, each enabling an individual to convey end-of-life wishes, in the event that he or she is unable to communicate:

• A Health Care Proxy (also known as a Health Care Power of Attorney) allows you to appoint a person you trust as your health care agent who is authorized to make medical decisions on your behalf.
• A Living Will allows you to document your wishes concerning medical treatments at the end of life.
• A Do Not Resuscitate Order (also known as a DNR) is a physician’s order that directs health care professionals and/or emergency medical personnel to refrain from performing cardiopulmonary resuscitation (CPR), if your heart or breathing stops. A DNR is only completed when someone is chronically or seriously ill.
• An Organ Donor Designation allows you to document your wishes regarding donating your organs after your death. Even if you have indicated that you would like to be an organ donor, your family or health care proxy/agent must give their permission in order for the donation to take place.

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Do we need a DNR?
In New York State, hospice does not require a patient to elect a Do Not Resuscitate Order (DNR). While most patients choose a natural and peaceful dying process when that time comes, some patients elect hospice while still requesting resuscitation attempts to occur.

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What parts of hospice are covered under Medicare, Medicaid and private insurance?
Medicare, Medicaid and most insurance plans cover most of the costs associated with hospice care related to end-stage illness. This includes a team staffed with a nurse, social worker, physician, chaplain, volunteers and home health aids delivering skilled pain and symptom management, counseling and assistance with activities of daily living, as well as medications, supplies and equipment needed to manage the end-stage illness. Many patients also elect to pay privately for additional hours of home health aide services at home.

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Do we have to stop treatment aimed at a cure to get hospice care?
While most hospice programs require patients to forego curative treatments which are likely to cause more burden than benefit, some therapies may continue for a limited period of time.

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What do we do in case of an emergency?
VNSNY Hospice has 24-hour phone availability to provide counsel, education and delivery of medications if needed. Additionally, clinical staff are available 24 hours a day to visit, if necessary.

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How do I get my family member into hospice care?
Patients, families or health care providers can call the VNSNY Hospice and Palliative Care Referral Center at 212-609-1900, seven days a week for more information and to make a referral. Our referral team will contact both your physician and your insurance for additional information. Usually patients can be admitted to hospice care within 1–2 days of the referral.

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