Hospice care is centered on the patient. It is a certain philosophy of care. It looks at treating the person rather than treating the disease. The focus of hospice care is quality of life, and uses a team of compassionate professionals to surround the patient with support. Support for the needs of the physical body, the spiritual person and the emotional self. Everything is taken into account to give the patient the most heart-centered care. Visitors are encouraged.
The word hospice originated from the Latin word for guest-house. Originally it was used to name a place of shelter for weary and sick travelers coming home from religious pilgrimages. The term was appropriated in the 1960s when British doctor Cicely Saunders began the hospice movement to compassionately care for the dying.
Is hospice care only for people who are dying?
Hospice is for people whom doctors have given a set time of life expectancy. We all have a limited life expectancy, but hospice is for those who have a life-threatening illness that makes death more likely.
Who is best suited for hospice care?
People best suited for hospice care are those people suffering from a serious medical condition. Usually this means an illness that is clearly life-threatening. This illness makes each day more difficult for the patient and those close to the patient. So hospice is there to help the patient, as well as their loved ones. The patient may be experiencing physical pain and needs to be consistently monitored to ensure they are not suffering needlessly.
The patient may be suffering difficult symptoms like nausea, extreme fatigue, and shortness of breath. These symptoms may be caused by the disease itself or by the treatment for the disease. This may often cause the patient to become depressed or anxious. Often feelings of rage and powerlessness drain energy, and hospice is specially equipped to support these difficult mental states as well as physical strain. The care hospice specializes in is best for situations such as heart disease, cancer, COPD (emphysema) and advanced dementia. This means hospice is meant for seriously ill patients who have chosen to prioritize quality of life.
Doesn’t choosing hospice mean giving up on recovery?
Choosing hospice does not mean you are giving up. Even if your loved one’s illness has advanced to a place where a cure is not likely – or not likely enough to risk the pain of further treatment – that doesn’t mean you are failing to do what you can.
As a matter of fact, an emphasis of quality of life and on giving the patient the most humane treatment gives them the room and support to focus on what’s most important to them. This gives them the energy to focus on family and allows their last months to be positive. Each person is given a choice for hospice or other methods of care, and each person knows what’s best for them.
Consulting your loved ones and the patient for a clear understanding of what they want is essential. With the guidance of social workers, chaplains, nurses and case managers, the best option becomes clear. Hospice helps families spend quality time together, heal old wounds, and support each other during a stressful yet natural occurrence.
What are the eligibility requirements for hospice care?
- Residence in the local area served by the hospice
- An attitude of allowing death to come naturally without extraordinary intervention
- Consent of your doctor and the patient
- Life expectancy of six months or less
- Focus on comfort rather than cure
- Adequate medical coverage or means
Should we wait until the doctor recommends hospice?
You are free to wait, but usually doctors allow the family to bring up hospice options. This is often why people receive hospice care so late in the process of their treatment. Weekly home visits from nurses who specialize in easing of pain and distress are available, so ask your doctor if hospice should be considered now or in the future and make plans accordingly. When you are honest with yourself, and wouldn’t be surprised if your loved one were to die in the next year, that’s the time to ask your doctor if hospice is the right choice.
When is the most optimal time to begin hospice care?
We have heard that many patients wish they knew of hospice care sooner, and would have benefited from this special treatment much earlier. Studies have shown that hospice care often improves the quality of life and improves how long a patient lives. Families that choose hospice care very near the end (a week or a few days) have been shown to have a harder time coping during the bereavement period than those whose loved one’s received hospice care for an extended time (six months to a year).
If it’s even a question in your mind that your loved one may benefit from more personal symptom management, such as assistance with bathing and grooming, emotional and spiritual support, ask your doctor’s opinion if hospice is right for your family. It’s always better to ask sooner than regret missing the opportunities that hospice has to offer.
What services can we expect to be included in hospice care?
A team of trained professionals provide hospice care. This team is made up of doctors, nurses, home health aides, volunteers, clergy and social workers. With treatment provided by this team, the caregivers and family can focus on the wellbeing of the patient and making the best of every day.
The hospice team makes regular visits to the patient and is available at all times for an emergency. Hospice coordinates all needed health care services. That means the first person to call for a health care need is the hospice team head nurse. Even before calling 9-1-1, the hospice nurse will determine the best plan of action for the patient, as they have been specially trained to do so.
Can I still use my doctor or do I have to use the hospice doctor?
You may use the doctor of your choice while in hospice care. You may also bring in new doctors to work together with the hospice team. Hospice never limits your choices, only assists you in your choices.
Who pays for hospice care?
If the patient meets hospice eligibility standards and has Medicare, then our government will cover 100% of this cost. In this case there is no copay and no deductible. The use of the hospice staff is included, and all the medical supplies and prescriptions necessary for symptom management are entirely covered. People who do not have Medicare but have private insurance coverage should talk with their providers to find out their eligibility and what copays and deductibles may accrue. Medicaid also provides coverage, but varies state by state.
Once hospice care begins can you leave the program?
Anyone may stop hospice care at any time for a variety of reasons. They may choose to resume more aggressive treatment or experimental measures. Or, if the patient is beginning to recover and no longer meets the eligibility requirements, they may be released from hospice care and return at any time it is needed.
Is hospice a place?
Hospice is the name of a service, not just a place. Hospice specializes in physical, spiritual and emotional support at any place our patient calls home.
Can I live alone while receiving hospice care?
The patient may choose to live alone as long as they have access to a caregiver in their time of need.
Does hospice only treat cancer patients?
No. Hospice cares for patients with any life-threatening illness. The most common need for hospice is for patients suffering from cardiac and respiratory diseases, renal disease, and neurological illness such as AIDS, cirrhosis, Lou Gehrig’s disease and Alzheimer’s disease. Anyone who is in need of pain management and emotional support due to an illness may receive hospice care.
Does hospice “dope up” people so they sleep all the time and become addicted to the care?
When people are in chronic pain they are in real need of prescriptions and do not become addicted to it. Hospice staff has the training to manage symptoms so the patient is comfortable and also alert so they may take advantage of each day’s opportunities. This always varies due to the medical and mental state of the patient.
Will hospice take away my prescriptions?
The hospice team works with the patient and doctors to manage pain and symptoms. In regards to a terminal illness, it may be necessary to change or stop a medicine. This may be a simple change or a very complex one. Since the hospice team is expertly trained, they will be monitoring the patient’s needs constantly to assure them of the most appropriate prescriptions.
Will hospice take my property to pay for my care?
Sometimes hospice care is confused with Medicaid benefits for long term care. You must meet financial criteria for Medicaid to pay for long term care. However, this is not so with hospice care. Hospice care is based on medical need and will be paid by insurance like any medical care.
Is hospice reserved for bed-ridden or housebound people only?
Hospice is not just for people who are immobile. Most hospice patients live their daily lives and need assistance. Where they are is where the hospice professionals set up their equipment. This may be a personal home, or a retirement center or assisted living facility. Hospice care teams are very flexible, and work to bring an added measure of peace and support to your lives at this difficult period.
Updated: March 28, 2014