Understanding Hospice

W hat comes to your mind when you hear “Hospice”? What do you visualize when you hear that someone is receiving hospice care? I am sure that there are many thoughts and ideas about hospice. Hospice is based on high-intensity personal care. The expectation is to provide a level of care that makes your loved one’s last days more meaningful. Hospice is all about living until it’s time to die. Your life is full of choices. Over 70% of Americans say they would prefer to die at home. Fewer than 25% achieve this goal.

Hospice was originally a word that was used to describe a place where a weary traveler could stop, rest and eat before continuing on with their journey. It is now used to describe the care that individuals get when they are diagnosed with a life-limiting illness., Hospice, as we now know it, originated in London. The goal was and is to provide pain control and supportive care to those with an incurable illness. In doing this, the expectation for the patient is to live out their life with the highest quality possible.

Hospice care focuses on the physical and medical needs of the patient. As well, the focal point is on the emotional, social and spiritual needs of the patient and their family. An interdisciplinary team provides support and care to the patient and family. This team is comprised of the medical director, primary care physician, nurses, social workers, home health aides, therapist, chaplains, volunteers, the family, and the patient. The care provided is directed, as much as possible, by the patient in combination with the family and hospice staff. There are scheduled visits made with the patient and primary caregiver, but services are available on an on-call basis 24 hours a day 7 days a week. Hospice care is usually provided in the home but can also be provided in assisted living facilities or nursing homes. Hospice care is directed at controlling symptoms and having effective pain management. Bereavement support is also provided for at least 13 months.

There are key elements that must be present before a referral to hospice can be made. The referral must come from a doctor. The physician indicates that the patient does have a terminal illness with a life expectancy of less than 6 months. If the care is to be provided in the home, it is important to have a friend or family member willing to be primary caregiver. In addition, the patient needs to have an understanding of the type of care they will receive. Hospice care isn’t focused on finding a cure. Its expectation is again to provide end-of-life care that is peaceful and pain free.

Hospice is paid for through a variety of sources. If eligible, payment can be made through Medicare Part A, Medicaid, or other private insurances. The following benefits are available if they are related to your terminal illness and are part of the plan of care: supplies, medications, durable medical equipment (i.e., hospital bed), home visits by hospice staff, respite, lab tests, outpatient procedures to alleviate symptoms, as well as general inpatient if related to management of symptoms.

The time after someone is referred for hospice is a challenging and difficult time. It is important that the referral not be made too soon or too late. If the patient, family and doctor are still seeking a cure, it is too early. It is too late when death is very near and there is little or no time for hospice care to make a difference. Hospice care, when begun at the right time, can and does make a valuable difference in the lives of the patient and family by making available time more meaningful.

If you would like more information, call Steve Shaw at 205-583-4673.

Published in November/December 2004 issue of Prime LifeStyle of Alabama, Birmingham Edition.