Hospice: A primer
By Emily Starbuck Gerson
When your loved one is dying of an incurable illness, spending those last months and days in a bland hospital room with busy doctors does not provide much comfort. Hospice is an alternative program that helps those with terminal illnesses enjoy the highest quality of life at the end in the comfort of the home or another chosen facility. The majority of those under hospice care are suffering from cancer, but it also includes people coping with end-stage heart disease, dementia, lung disease, and other fatal conditions.
The hospice philosophy
Hospice is a palliative care program that does not focus on curing the illness, but rather making the sick person comfortable, both physically and emotionally, and even socially and spiritually. The program emphasizes compassion and personal attention. It does not try to postpone death or even hurry it; the dying process is treated as a normal part of life and is openly discussed. The hospice plan includes both the wishes and the needs of both the family and the ill person.
How it works
Hospice programs employ both medical professionals and volunteers, all of whom are highly trained in end-of-life care. They assigned to an ill individual and will develop a customized plan of care for each patient. The medical experts focus on providing nursing services, medical equipment, and managing pain with pharmaceutical drugs. The volunteers are there for moral and practical support; they can help with household tasks, can serve or feed the patient meals, and will provide the sick with bedside company and conversation. It is their job to provide the utmost happiness and comfort to the dying.
The hospice volunteers and staff are also a major resource to the ill person’s family. They can answer questions about the dying process to allay fears and worries, teach the family what they can do to help, and provide support for grief before and after the death. Hospice staff and volunteers are available every hour of the day, every day of the year.
There are several different levels of hospice care. They range from the ill person staying in the home and receiving occasional visits from hospice staff to continuous care for medical crises. There is a respite care option for caregivers who simply need to be relieved of their duties for a few days, and options for patients who need to be in a long-term facility such as a hospital or nursing home.
How long a patient is under hospice care can vary greatly from case to case. In 2003, Hospice of Texas found that 36.9 percent of those under hospice care died within seven days or less. The average length of service was 55.52 days, while the median length of service was 22.22 days. Some people are in a hospice program for much longer; 7.3 percent of those in hospice care died in 180 days or more.
Finding a local hospice
If you need a hospice program for yourself or a loved one, you have many options; it is estimated that there are 3,300 hospice programs in the United States. To find a local service, you can contact your state’s department of health and social services and ask for a list of licensed hospice agencies.
You can also ask your physician or hospital to help you locate a local hospice or you can get a referral from the American Cancer Society, an agency on aging, your local United Way chapter, a Visiting Nurse Association, or even your place of worship.
Additionally, you can find listings for hospice programs by Googling the term “hospice” and the name of your city. You can also look in your local phonebook.
Paying for hospice
Hospice generally comes at no cost to patients who have worked, as hospice services are paid for through Medicare payroll deductions. It is estimated that 94.7 percent of hospice programs are Medicare certified. Additionally, most commercial insurance plans and Medicaid cover hospice with little to any out-of-pocket expenses.
Hospice coverage includes nurse visits, consultations with doctors, medications for your illness, medical equipment, home healthcare aids, emotional and spiritual support from chaplains and social workers, care at home, round-the-clock care for medical crises, respite care to relieve the family, and even 13 months of bereavement support for the family left behind after the patient’s death.
If you want your loved one to enjoy the greatest quality of life in their final days and if you want support throughout the process, enrolling in a hospice program is a wonderful option.
