Tips for Family and Caregivers

It’s difficult to watch a loved one decline in health but it’s up to you to acknowledge the progression of your loved one’s illness. It’s up to you to discuss with them what their wishes are for their care and plans for their death as uncomfortable as it may be.

This is a list of things that will help you through the hard times.

What are Advance Directives? Advance Directives provide you a way to communicate to your family, friends and health care professionals what kind of medical care you want if you were too ill or hurt to express your wishes. Advance directives are legal documents that allow you to convey your decisions about end-of-life care ahead of time.

A living will tells how you feel about care intended to sustain life. You can accept or refuse medical care. Issues to consider and put into writing include;

  • The use of dialysis and breathing machines
  • If you want to be resuscitated if breathing or heartbeat stops
  • Tube feeding
  • Organ or tissue donation


A durable power of attorney for health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions if you are unable to do so.

Take time to learn about your loved one’s illness. Ask questions. Educate yourself on what you can expect and what resources are available to help you. Remember to keep them involved in the decisions that need to be made. Respect their wishes.

Home care offers an alternative to your loved the opportunity to heal at home. Often, when someone is required to leave home to receive long-term care, it signifies a loss of independence and this can cause depression and a feeling of being a burden on the family.

With home care your loved one is able to stay in their home with the assistance of health care professionals in a cost effective way to regain their independence. Close communication continues with their physicians and you as the family and caregivers. Education is provided to you on how to care for them. You are able to ask questions and expect outstanding care.

When the end-of-life is growing closer, your home health can assist you by talking to you, your loved one and their physician about end-of-life care. What is end-of-life care? It’s hospice. Hospice provides a team approach for support, assistance with medications, pain control, counseling and skilled staff. Hospice allows the patient to die in their own home with dignity, comfort and the assurance that the ones they care for will receive bereavement support after their death. With the support of their hospice team, the dying process will be a more comforting experience for them and you.

Our professional, experienced social worker and Chaplain will provide the emotional support for you and your family.  They will suggest other avenues for additional support as needed.  It’s also suggested that you seek support from friends that have had similar experiences, other family members, your church and your hospice and home health team. Don’t try to go it alone. Seek support, you will need it.

Frequently Asked Questions

Home Health care is skilled care provided in the comfort of a patient’s residence by a skilled nurse or therapist. Care is focused on helping individuals manage a chronic condition and/or recover from illness, surgery, accident or change in medical status. At Pacific Home Health & Hospice, we create individual care plans specific to the patient’s needs.

Medicare pays 100 percent for those who qualify. Medicaid and private insurance may also pay for home care. Benefits vary by policy and verification of benefits is required.

Patients must be 65 years of age or older, have a skilled need and be homebound. The primary care physician must provide a referral and order for home health care. Patients younger than 65 may qualify if they have received Social Security disability benefits for at least two years or they currently receive Medicare disability benefits.

Medicare considers you homebound if you have extreme difficulty leaving the home, even with assistance from another person and/or an assistive device.

Yes. However, the patient must meet the following criteria:

  • The patient’s physician has established a plan of care, including the request of home health care services.
  • The patient is homebound.
  • The patient is in need of a nurse’s care or requires reasonable speech or physical therapy that is considered a necessity throughout the completion of care.
  • The care needed is part-time and intermittent.

No, Medicare does not consider this a skilled need but we can provide resources to obtain a caregiver. 

Hospice is a service. It is designed to provide a caring environment for the physical, spiritual and emotional needs of the terminally ill. Care can be provided for patients in their home, a nursing facility or a foster care home without repeated hospital stays. The goal of Pacific Home Health & Hospice personnel is symptom management and pain control. Hope of remission or cure is never abandoned but the focus is on providing palliative (comfort) care not curative care. Our services allow patients to retain their dignity while realizing quality is more important than quantity in their remaining days.

Not always, hospice care can be provided in most long-term care facilities, nursing homes and assisted living facilities.

Once a patient has been diagnosed with a life-limiting illness and life expectancy is less than six months, a physician then refers the patient to hospice. Once it is confirmed the hospice patient and caregivers understand the definition of hospice care and that it is aimed at comfort rather than an actual cure, a form called “Election of Benefit” will be signed by the patient and then hospice services begin.

Home Health focuses on patient recovery. Hospice focuses on facilitating comfort and providing support when recovery is no longer an option. Hospice care is provided by an interdisciplinary team of specialists including physicians, nurses, grief support counselors, social workers, aides, and volunteers. At Pacific Home Health & Hospice, hospice centers on the patient and family. Family focus is imperative, as caregivers must feel empowered to care for the patient. Furthermore, family members must be prepared to manage the inevitable grief that accompanies this process. That is why our entire team supports the family while hospice care is actively being provided to the patient, along with offering grief counseling and bereavement after death of the loved one.

Medicare pays 100 percent for those who qualify. Medicaid, private insurance and HMOs will also pay for hospice care. Benefits vary per policy and verification of benefits is required. Most insurance policies cover the entire cost of hospice services, although some may require a co-pay.

The patient can then be discharged from hospice care to return to some form of aggressive treatment and even resume daily life. Additional coverage is allowed by Medicare and by most insurance should the patient need to return to hospice care.

A physician must refer a patient to hospice after medically determining the patient has a terminal illness. At that time the patient would proceed with the qualifications process.

The patient and their family should always feel free to discuss this type of care with their health care professional(s) and even their friends, because it is necessary to prepare for the type of care the patient wishes to receive at the end of life.

Our offices are open from 8 a.m. to 5 p.m., Monday through Friday. A registered Nurse is always on call weekends, evenings and holidays for those who are on services.

Once a patient is referred to Pacific Home Health & Hospice for hospice care, the office will contact the patient’s physician to ensure hospice care is appropriate for the patient. A staff member will contact the hospice patient or caregiver confirming that the patient understands the definition of hospice care and that it is aimed at comfort rather than an actual cure. A form called “Election of Benefit” will be signed by the patient and then hospice services begin.