Somewhere in the first weeks of home hospice, most families hear the word respite and take it to mean that someone will come and take the patient for a while so the family can sleep. That is partly true. The hospice benefit does include a respite stay. It is narrower than the word suggests, and the narrow parts are where the cost lands.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
What the benefit covers
Under Medicare's hospice coverage, a patient who has elected hospice may receive inpatient respite care on an occasional basis. The stay exists so the family can step away from the hands-on work for a short time. It is not a new hospice admission, and it is not a way of moving the patient out of the home for good.
Three limits matter most. The stay is covered for no more than five consecutive days each time it is used. It must take place in a setting the hospice has arranged, which is usually a hospice inpatient unit or a facility with an agreement with that hospice. And the hospice team stays responsible for the plan of care while the patient is away. Ask the hospice to show you these three points in writing before you build anything on them. The federal rules behind them are listed on the Sources page.
What the benefit does not cover
The benefit pays for the inpatient stay. It does not automatically pay for everything around the stay. Ask about each of these separately, because each one can add a line to what the break costs you.
Transportation to and from the facility. Ask whether the hospice arranges a ride, whether that ride is at no cost to you, and what happens if the family drives instead. If you drive, count the miles and the hours both ways.
Any coinsurance or copayment on the respite days, and whether the hospice's own policy adds anything. Ask for the number in writing. Do not assume it is zero because the stay is covered.
Help in the home during the hours you are off. A respite stay gives the patient a bed elsewhere. It does not pay for someone to cover your work at home, and a hired or in-home non-medical caregiver brought in for those hours is a separate arrangement with its own price.
What to check before you book the day
Ask the hospice how many respite days have already been used in the current period, and have them say the count out loud on the phone and then confirm it in writing. Then confirm the following.
The facility, its intake hours, and whether it has a bed on the day you need. Ask about the arrival hour as well as the date, since an evening arrival can be harder to staff than a morning one.
What the facility wants with the patient on arrival. Ask for the list in writing: the medicine list, the equipment the patient uses, the clothing, and the name and number of the hospice on-call line. Confirm with the hospice and the facility who receives the medicines at intake, so there is no gap at the door.
What happens if the patient needs more care than the stay was planned for, and how the hospice reaches you during the stay. Write down the number you will call and the name of the person who answers it.
The return. Who brings the patient home, at what hour, and whether the bed, the equipment, and the room are still set up the way you left them.
What the break is for
Five days is a short break, and the return can be as tiring as the departure. Plan the first night back before you leave. Have the room ready, the medicine list on the counter, and the hospice number where you can reach it without searching. Treat any hours you gain as rest, not as a window to catch up on everything the house has been waiting for.
If the numbers do not work, say so to the hospice team early. They can tell you what the benefit covers in your case and what it does not, and that answer is more useful to you at two in the morning than a plan that falls apart on the first evening.