What is Hospice?
Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. Hospice care neither prolongs life nor hastens death but is designed to improve the quality of a patient's life by offering comfort, pain management and dignity. The Hospice team and volunteers offer a specialized knowledge of medical care, provide team-oriented care and address all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.
Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends. Hospice also offers a variety of bereavement and counseling services to families before and after a patient's death.
How do I initiate hospice services?
Patients should be referred to hospice when life expectancy is approximately six months. While patients must have a doctor's referral to enter hospice, the patient, family and friends can initiate the process by contacting a local hospice provider, discuss the patient's needs, ask questions, and even have a hospice representative discuss options at a family meeting. The patient and caregiver has the final decision on what services and hospice health care is provided.
Before providing care, hospice staff coordinates with the patient's personal physician(s) and a hospice physician to discuss patient history, current physical symptoms and life expectancy.
The hospice staff then is able to admit and assess the patient. It is important that the hospice staff meet with both the patient and their family and discuss the hospice philosophy, available services and set up expectations. They may also discuss pain and comfort levels, support systems, financial and insurance resources, medications and equipment needs.
A "plan of care" is then developed for the patient and the hospice team visits are scheduled. This plan and schedule is regularly reviewed and revised according to patient condition.
Bereavement services and counseling are available to loved ones for a year after the patient's death.
If you have further or specific questions contact a local Hospice Provider.
How does someone qualify for Hospice?
Hospice care is a covered under Medicare for patients with a prognosis of 6 months or less. A patient can remain in hospice care beyond six months if a physician re-certifies that the patient is terminally ill. Additional eligibility requirements can be found here.
What benefits are covered under Hospice?
This benefit covers all services, medications and equipment related to the illness. These include
- Physician services
- Nursing services
- Home health aides
- Medical appliances and supplies
- Spiritual, dietary, and other counseling
- Continuous care during crisis periods
- Trained volunteers
- Bereavement services
Hospice services are covered under Medicare. Nearly all states and the District of Columbia offer hospice coverage under Medicaid. Many private health insurance policies and HMO's offer hospice coverage and benefits. Hospice services are covered for military families under Tricare.
There are several common myths about hospice. Here are a few:
Myth #1: Hospice is only for people with cancer.
Any patient who has a terminal diagnosis specified by the attending physician qualifies for hospice service. More than one-half of hospice patients nation-wide have diagnoses other than cancer. Increasingly, hospices are serving families coping with the end-stages of chronic diseases, like emphysema, Alzheimer’s, cardiovascular, and neuromuscular diseases.
Myth #2: My loved one will die sooner if placed on hospice.
On average, research shows that when a person receives hospice care they live longer with a better quality of life. Hospice does not hasten the process of death, but simply allows natural processes to take place while preserving dignity and comfort.
Myth #3: Hospice is only for people who can accept death.
While those affected with a terminal illness struggle to come to terms with death, First Choice hospice meets the family where they are. We welcome inquiries from families who are unsure about their needs and preferences. Hospice staff are readily available to discuss all options and help families facilitate decisions.
Myth #4: Hospice is a place.
Hospice care takes place wherever the need exists - usually the home of the patient. Patients residing in assisted living facilities and even skilled nursing facilities under certain conditions.
Myth #5: Hospice care is all the same.
Even in the same community, hospices may vary especially in the scope of services offered and what supplies, durable medical equipment and medications will be paid for by the hospice.
How did Hospice services start?
The word "hospice" stems from the Latin word "hospitium" meaning guesthouse. It was originally used to describe a place of shelter for weary and sick travelers returning from religious pilgrimages. During the 1960's, Dr. Cicely Saunders, a British physician began the modern hospice movement by establishing St. Christopher's Hospice near London. St. Christopher's organized a team approach to professional caregiving, and was the first program to use modern pain management techniques to compassionately care for the dying. The first hospice in the United States was established in New Haven, Connecticut in 1974.
Today there are more than 4,700 hospice programs in the United States.* Hospice programs cared for 965,000 people enrolled in Medicare in 2006,** and nearly 1.4 million people in the United States in 2007*.
Hospice is not a place but a concept of care. Eighty percent of hospice care is provided in the patient's home, family member's home and in nursing homes. Inpatient hospice facilities are sometimes available to assist with caregiving.
(Information provided from the Hospice Foundation and First Choice Home Health and Hospice of Utah)
What steps can I take to increase the quality of Hospice and end-of-life care?
Patients and families will increase care and decrease anxieties by doing the following:
- Research and interview hospice companies and learn what to expect from end-of-life care.
- Request information from health care professionals and research your diagnosis, treatment options and prognosis.
- Discuss your fears, anxieties, values, and preferences with your family, the hospice team and physician. They want to be involved.
- Select a healthcare agent, who can make healthcare decisions for you when you are unable to, by filling out the Advance Directive form.
- Discuss your end-of-life preferences with your healthcare agent and other loved ones through a living will and conversations.
- Ask your physician to fill out a Physician Order for Life-Sustaining Treatment Form that will allow all healthcare providers to honor your end-of-life care treatment wishes.
On a more personal level, patients and families will benefit by doing the following:
- Family members, particularly the healthcare agent, need to be an advocate for their loved one.
- Tell those you love that you love them and if able, write letters, record a video, or record your thoughts and feelings about them.
- Say your goodbyes to those you care for.
- Forgive individuals who have hurt you and say sorry to those you have hurt.