Frequently Asked Questions

Having a terminal illness or caring for someone with a terminal illness is never easy. These answers to common questions may help you understand your options if the goal changes from curing the disease to providing comfort and improving quality-of-life.

Hospice care provides comprehensive, compassionate care and support for people with life-limiting conditions and support for their families. Hospice care seeks comfort rather than a cure. Hospice care bypasses most diagnostic testing and treatments that may prolong life or increase suffering.

Receiving hospice services does not mean an individual is about to die. Hospice care focuses on quality-of-life. Hospice care helps people take pleasure in their family, accomplish goals, and enjoy life. Hospice is about how people live with a terminal illness.

The RiverStone Health Hospice Services team includes a medical director, nurses, aides, social workers, chaplains and volunteers. We work together to keep the patient as pain-free, comfortable, and symptom-free as possible and to allow patients to remain in the home of their choice until their death. We also support the family, easing many of the burdens of a terminal illness.

RiverStone Health Hospice Services, which began  as Big Sky Hospice, was the first hospice program in the region and has offered compassionate hospice care to the community for more than three decades.

  • Families have access to the hospice team by phone 24 hours a day, 7 days a week.
  • We are nationally recognized for our standard of excellence by the Community Health Accreditation Program (CHAP). We are the first provider of hospice services in the region to receive this recognition.
  • We are committed to providing care that treats the person, not the disease and emphasizes the quality of life, not the duration.
  • We honor wishes, wants and needs.
  • We are so committed to quality hospice care that we built the RiverStone Health Hospice Home, so that if an individual needs a higher level of hospice care we can provide it.
  • RiverStone Health Hospice Home is the only inpatient facility within 200 miles of Billings and can provide continuous care as an alternative to hospitalization.
  • Survey results show 98 percent of families who have used our Hospice Services would recommend them to others. (Results from the National Hospice and Palliative Care Organization, 2014.) We are licensed by the State of Montana and certified by Medicare and Medicaid, meaning that RiverStone Health Hospice Services meets state and federal guidelines.
  • We belong to the National Hospice and Palliative Care Organization, the National Home Care and Hospice Organization, and the MHA, an association of Montana Health Care Providers.
  • We participate in We Honor Veterans, a program to recognize and honor our country’s military veterans for their service.

Hospice care is appropriate when:

  • The doctor thinks that the patient will live six months or less if the disease runs its normal course
  • Aggressive treatments are not working or providing relief
  • The patient, family and physician agree and understand that the focus of hospice care is on comfort through pain control and symptom management, rather than a cure.

Hospice is a philosophy of care, not a place. Most hospice patients receive care in their home or the home of a relative or friend. Care can also be provided in many long-term care facilities, assisted living facilities, hospitals or nursing homes. RiverStone Health Hospice Home is the only inpatient hospice facility within a 200 mile radius of Billings. Staffed 24 hours a day, 7 days a week, it allows us to provide continuous care to terminally ill patients and their families as an alternative to hospitalization.

For most home health care providers, the goal is to help the patient get well. In hospice, the staff and family recognize that the patient will not recover. Care focuses on comfort and support, rather than a cure.

All members of the hospice care team – the physicians, nurses, social workers, chaplains, aides and volunteers – work together to coordinate care.

Hospice care focuses on the entire family. The hospice team teaches the family how to be involved in their loved one’s care.

Hospice care does not end when a patient dies. RiverStone Health Hospice Services staff and volunteers maintain contact with the family to provide grief support for 13 months after the death of a patient.

Hospice care becomes an appropriate choice when treatments are no longer effective or desired. The goal shifts to relief from symptoms, so patients can live their remaining days in comfort and dignity.  A physician referral is required to begin hospice care, but anyone can receive more information. Getting the full benefit of hospice care takes time. It takes time to manage and control pain and to relieve symptoms. It also takes time to build trusting relationships between the patient, family and the hospice service.  For these reasons, and to get the most from hospice care, services should begin as soon as possible after a cure is no longer an option.

Hospice is a covered service under Medicare, Medicaid and most insurance companies. RiverStone Health provides hospice care to patients in Yellowstone, Stillwater, and Musselshell counties. A sliding fee scale is available.

As their illness progresses, many patients have pain and other serious symptoms. Hospice staff receives special training to care for both physical and emotional pain and distress. The staff works with the patient’s doctor to make sure that medication, therapies and procedures are tailored to the goals of the patient’s care plan.

If patients improve, they can be discharged from hospice care. They may choose to seek aggressive treatment or resume daily life. Patients may request to have hospice care again at any time when they no longer desire aggressive care or symptoms are progressing.

RiverStone Health Hospice Services offers inpatient hospice services. Our 12-bed RiverStone Health Hospice Home provides hospital-level inpatient care as well as respite and general hospice care in a warm and comforting atmosphere. It is staffed 24 hours a day, 7 days of the week.

The patient and family should feel free to discuss hospice care at any time with their doctor, other healthcare professionals, clergy or friends. Many individuals who want to remain in control of their healthcare decisions prepare Advance Directives that spell out the type of care they want to receive at the end-of-life.

Anyone can refer a patient.  To be admitted, a patient must:

  • Agree to treatment aimed at comfort rather than a cure.
  • Have an incurable disease resulting in a limited life expectancy of six months or less, as certified by a physician.

If your family member is too ill to make decisions, then you as the family caregiver may be the one to decide about hospice care. It helps if you have discussed the subject ahead of time with the patient and other family members. An Advance Directive is a legal document that appoints someone to speak on behalf of people if they are incapable of making decisions.

When a patient is referred to RiverStone Health Hospice Services, staff contacts the patient’s doctor to make sure the doctor agrees that hospice care is an appropriate option. The patient signs a consent form to confirm the understanding that the goal of hospice care is to provide comfort and pain relief, rather than a cure.

The RiverStone Health Hospice Services team provides these services in a patient’s home or in another setting:

  • Managing pain and other symptoms to ease suffering.
  • Supporting patient and family through the emotional, psychosocial and spiritual aspects of dying.
  • Providing medications, medical supplies and equipment.
  • Teaching family members skills needed to care for their loved one.
  • Providing regular nursing visits to evaluate symptoms, adjust medications, and consult patient and family about the changes which are occurring.
  • Providing certified hospice aides to assist with bathing, light housekeeping and meals.
  • Offering counseling for patient and family to help cope with end-of-life issues, assist with understanding Medicare and Medicaid, and help in coordinating community resources.
  • Delivering special services such as speech and physical therapy if needed to improve the quality-of-life.
  • Making short-term inpatient care available when pain or other symptoms become too difficult to manage at home.
  • Five day respite care available to provide a short rest for the family.
  • Having a nurse available on-call 24-hours a day, 7 days a week to address questions, concerns and make after hours home visits if needed.
  • Providing grief support and counseling after the patient’s death.

No. Hospice care is for patients with any life-limiting illness when the normal course of the illness suggests that the patient’s life-expectancy is about six months. When hospice care was established in the United States in the 1970s, cancer patients made up the largest percentage of hospice admissions. Today, cancer accounts for less than half of all admissions. Hospice care is an option for patients with other diseases such as Alzheimer’s, heart disease, lung disease, Lou Gehrig’s (ALS), stroke, end-stage diabetes, liver disease, and kidney disease.

No. Hospice cannot provide a cure, but it can provide caring. Because patients get substantial relief from pain and other symptoms—and their families are supported by a caring hospice team—they can choose exactly how they will spend their final months of life. This means they can have a meaningful, dignified, and peaceful end-of-life experience.

No. Dying is a natural process and hospice services do not hasten or postpone death.

Meeting the needs of the patient and the family are top priorities. The family is at the center of all decision making. RiverStone Health Hospice Services recognizes that it takes many caregivers, both relatives and friends, to meet the unique needs of each patient.

No. RiverStone Health Hospice Services has unmatched expertise in managing pain so patients are comfortable, yet alert, and able to enjoy each day to the fullest extent possible. Hospice nurses and doctors are up-to-date on the latest medications and techniques for pain relief. Giving patients the medications they need to have their pain, anxiety or other symptoms controlled does not hasten death.

No. Hospice care can be provided when a cure is no longer possible. Hospice care is most beneficial when referrals are made as early as possible affording adequate time for symptom and pain management and the development of trusting relationships between patient, family, and the hospice care team. Unfortunately, many people enter hospice services too late to fully benefit from the many services available to them and their families.

Hospice may offer more help for caregivers than they are used to getting at home. Hospice teams recognize you as the primary caregiver and will show you and others how to care for your family member at home and talk to you about how to prepare for what lies ahead. You will also be offered bereavement services for 13 months after the death of your family member. The hospice team’s goal is to provide help and support when you and your family member most need it.