Comfort and Support at the End of Life
What is hospice?
Hospice is a philosophy of care that helps people with a non-curable illness live the remainder of their lives with dignity. This allows them to maintain a quality of life through superior, professional medical services such as pain and symptom management, emotional and spiritual support and respite care. It is a compassionate approach to end-of-life care. While the majority of hospice care is provided in a person’s home, hospice services can also be given in assisted living facilities, hospitals and nursing homes.
According to the National Hospice and Palliative Care Organization, the term hospice originated in medieval times as a way to offer respite to weary travelers. The name was first applied to specialized care for dying patients in 1967 by a physician, Dame Cicely Saunders, who founded the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London. As a formal program for end-of-life care, hospice took root in the United States in 1974 and became part of the Medicare benefit in 1983.
What are the benefits of hospice?
One of the greatest benefits of hospice care is that a person is not alone at this important time. Hospice staff works with the patient and family to achieve the patient’s goals for end-of-life care by providing a team of people to help the patient and loved ones cope with the challenges at the end of life. The patient and his/her family members are the most important part of the team, which may include doctors, nurses, spiritual care counselors, social workers, speech-language pathologists, home health aides and volunteers.
The hospice team helps:
- Reduce stress on primary caregivers
- Manage the patient’s pain and symptoms
- Provide 24-hour phone support
- Address emotional and spiritual pain
- Provide 13 months of bereavement support to the patient’s family after the patient has passed away.
Additionally, hospice helps ease financial burdens by covering the cost of prescriptions related to the patient’s diagnosis, as well as the costs for durable medical equipment like hospital beds and bedside commodes.
When is a person eligible for hospice?
A person is eligible for hospice when he or she does not want to pursue other treatments focused on curing the disease and when a physician certifies that the individual has six months or less to live if the illness runs its normal course.
In the past, mostly people with cancer utilized hospice. Today, individuals with illnesses including heart failure, emphysema, Alzheimer’s and liver disease all benefit from end-of-life care. In fact, non-cancer diagnoses now account for more than half of all hospice care nationally.
Are all hospice programs the same?
All hospice programs are not the same. Medicare requires that certified hospices provide a basic level of care, but the quantity and quality of services can vary significantly from one hospice to another.
How much will hospice cost?
Hospice is covered by most insurance, including Medicare and Medicaid. Some hospices also provide care for patients without funding or health insurance.
When is a person ‘ready’ for hospice?
Many people may be hesitant to consider hospice for themselves or loved ones because they feel that they are “giving up” on life—this is far from the truth. While an illness may not be curable, hospice strives to manage patients’ symptoms so that they may live the rest of their life with comfort and dignity. A good hospice program will ask the patient what his or her goals for end of life care are and then create a plan to help achieve those goals. A person only needs to be “ready” to accept help. A person may also elect to discontinue hospice services and resume aggressive treatments at any time. One consistent comment patients and family members make is that they wished they would have known about hospice sooner.
Does hospice provide bereavement support?
Hospice care includes bereavement support for the family for up to 13 months after the loss of their loved one. Hospices will differ in their program offerings, but may include follow up phone calls, in-person counseling visits, a memorial service, materials mailed to the home or grief support groups.
When should I start considering hospice as an option for care?
It is never too soon to discuss your options for end-of-life care. The best time to start talking about hospice is before a crisis happens. An advance directive will help make a person’s wishes for care known to his or her family and physician. It is perfectly acceptable to ask the physician about hospice. You do not need to wait for him or her to bring up the subject. You can also ask your friends if they have had experience with hospice, or call some hospices in your area and ask to speak with their staff. Health care professionals, clergy, neighbors or friends can often recommend a good hospice program.