Hospice care (also called end-of-life, comfort care) is a service that focuses on keeping a dying patient as comfortable and pain-free as possible during their last days. Terminally ill people choose this model of medical care as their lives come to an end. Hospice patients typically reach a point where they instead want to focus on the quality of days left, rather than specific treatment options.
Under hospice care, the primary goal is shifted from attempting to cure an illness to keeping a patient as comfortable and free of pain as possible. Hospice is unique in the medical field in that it provides an alternative to traditional medical care hospitals and nursing facilities commonly deliver. In addition to providing comfort, hospice also helps family members and friends by involving and training them in giving care, and providing both respite and counseling services to those in need.
Provided the patient meets certain criteria, Medicare and most insurance plans cover hospice care.
Hospice care has been growing in popularity in recent years. The National Hospice and Palliative Care Organization (NPHCO) estimates that 1.4 million patients received services from a hospice agency in 2008. It also found that 38.5% of all people that died in the United States were under the care of a hospice program.
Where is hospice care provided?
Many people think of “hospice” as care provided at a facility, and while that may be the case for some, the majority of hospice is provided directly in-home. A unique advantage is that hospice can be provided wherever a patient calls home, e.g. a hospital, nursing home, group home, assisted living or a dedicated hospice facility. Because hospice care is focused on easing pain rather than aggressive medical intervention, it usually does not require sophisticated machinery, such as life-support systems or dialysis devices.
What types of care are provided by Hospice?
Hospice services are provided by a team of caregivers (called an interdisciplinary group or IDG) and includes:
- medical care—a hospice Medical Director oversees and coordinates the care, working in conjunction with a patient’s primary care physician
- nursing care—provided either around-the-clock, or sporadically for check-ups or special services, such as administering injections, depending on the patient’s needs
- help with daily needs by a hospice aide, such as bathing, toileting, or cleaning
- social services support, such as help with insurance and financial matters
- visits from a spiritual (non-denominational) counselor, if requested
- physical, speech, dietary, and occupational therapists
- counseling services, both for the patient and family members
- short term inpatient care, including respite care to provide breaks and rest time for caregivers, especially family members
- medications to help control pain and symptoms
- medical supplies and equipment—such as hospital beds, walkers, and oxygen
- bereavement care
Qualifying for Hospice Care
To qualify for hospice care, both the Hospice Medical Director and a patient’s primary doctor must certify that a patient has a terminal illness. The certification states that if the disease runs its normal course, the patient will probably have six months or less to live. In reality, it is often difficult or impossible for doctors to put a specific timeline on a patient’s life.
In addition to a physician certification, the patient must sign a statement choosing hospice care instead of standard Medicare covered benefits, called an Election of Benefits form. While on hospice, Medicare will still continue to cover health problems that are not related to the terminal illness.
Since every disease process is unique to the individual, the benefit allows for the option to start/stop hospice care as a medical condition worsens or improves. For example, it may be appropriate for a person whose cancer goes into remission to discontinue hospice care, but resume later if symptoms recur. It’s also acceptable for a patient to stop hospice care simply because he or she has a change of heart or is anxious to try a new type of medical treatment.
If you or a loved one are considering hospice care, please give us a call. Let our experienced staff members meet with you to discuss your options and understand your wishes. We will be glad to work directly with your Doctor and any other healthcare provider you may already have.