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Senior Citizen's Guide

What is Hospice?

What is hospice?
Hospice allows a terminally ill patient to spend their last days at home, in familiar settings, with their loved ones. Hospice began in the 1970's, growing from the idea that modern medicine was depriving the natural dying process of its family ties and robbing it of its dignity.

Since that time hospice has grown tremendously. There are now more than 3,000 hospices nationwide and over 100 in Pennsylvania. The service hospice provides focuses on maximizing the quality of remaining life by addressing the physical, social, emotional and spiritual needs of terminally-ill patients and their families. Hospice focuses on relieving a patient's pain and making them as comfortable as they want to be so they can make the most of the time that remains. Hospice provides complete support for the entire family.
Care is delivered in the home or an inpatient setting and is provided by a medically directed interdisciplinary team. Each team includes a physician, nurses, social workers, clergy, home health aides, therapist, and any number of volunteers. Bereavement support is provided to both families and caregivers. The type and scope of services provided is based on ongoing needs assessments and is unique to each patient and family.

What services will hospice provide, and who will perform them? The core services hospice provides are: nursing, social services, physician, counseling, home health aide and homemaker services, and bereavement. Hospice staff and volunteers will provide assistance in almost anyway you need, while encouraging patients to be as active and self-sufficient as possible. No job is too big or too small for the hospice team.

What does the hospice admission process involve?
One of the first things hospice will do is contact the patient's physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Hospice may have medical staff available to help patients who have no physician.) The patient will also be asked to sign consent and insurance forms.

The so-called "hospice election form" says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control) rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage for a terminal illness.

Is hospice care covered by insurance?
Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in some 42 states, and by most private health insurance policies. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

Does hospice provide any help to the family after the patient dies?
Hospice provides continuing contact and support for family and friends for at least one year following the death of a loved one. Most hospices also sponsor bereavement and support groups for anyone in the community who has experienced the death of a family member, friend, or loved one.

Does hospice do anything to make death come sooner?
Hospices do nothing either to speed up or to slow down the dying process. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
How does hospice "manage pain"?
Hospice nurses and doctors are up-to-date on the latest medication and devices for pain and symptom relief. In addition, physical and occupational therapists assist patients to be as mobile and self-sufficient as possible, and they are often joined by specialists schooled in music therapy, art therapy, diet counseling, and other therapies. Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these as well. Counselors, including clergy, are available to assist family members as well as patients.

Editorial provided by The Pennsylvania Hospice Network, www.pahospice.org.

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