Hospice

What is hospice?

The term hospice was used long ago to refer to a type of lodging for travelers. Hospices were places where travelers could find rest and comfort during their journeys. Today hospice refers to a concept of compassionate, end-of-life care for people in the final phase of a terminal illness.

If you are ill and have a life expectancy of 6 months or less, hospice may be a better choice for your care than a hospital. Your healthcare provider, other healthcare professionals, family, friends, or clergy may make the referral to hospice.

Hospice seeks to neither hasten nor postpone death. The emphasis is on quality of life and dignity. Hospice recognizes your social, emotional, and spiritual needs as well as your physical needs. The hospice staff can help prepare you for a peaceful death at home or in a homelike setting.

Who qualifies for hospice care?

There are a variety of diagnoses that qualify people to be admitted into a hospice program. The most important part of the diagnosis is that the doctor expects that you will die from your illness within 6 months if the illness follows the normal course. In some cases you may live longer than this but if you are not getting better, you may be able to keep receiving hospice care for more than 6 months.

Sometimes, there is not a clear diagnosis but a combination of diagnoses that qualifies someone for hospice. The frail elderly may fit into this category. While they do not have one specific disease that will take their life, they have several health problems that in combination are likely to cause death in 6 months or less. Just because you may be frail and elderly does not mean you automatically qualify for hospice care. You must also have the prognosis of living no longer than 6 months based on your illnesses.

Treating the whole person

Hospice care is provided to both you and your family. All of you are involved in making decisions with your healthcare provider and hospice staff. Whenever possible, you are encouraged to make decisions about your treatment, relationships, and personal business. You will also be encouraged to voice your preferences about burial and memorial services. Grief counselors will give counseling to your family for about a year after your death.

Providing a team approach

A team of trained professionals provides hospice services. The team includes doctors, nurses, chaplains, social workers, physical therapists, hospice aides, pharmacists, dietitians, grief counselors, and volunteers. The team members work to address your medical, emotional, psychological, and spiritual needs as you near the end of your life.

Controlling pain

Pain control is one of the skills that the hospice staff specializes in. Most patients want to have their pain controlled in a way that still allows them to be alert enough to participate in some minor activities. The hospice team will work with your physician to ensure that you are as comfortable as possible. Having your symptoms controlled will help you have a better quality of life.

Types of hospices

Most hospices are available to help with your needs day or night, 7 days a week. Typically, care is offered at home. It is also offered in nursing facilities or a hospice house. The hospice house may provide either a residential level of care (as though it were your own home) or an inpatient level of care (as though you were in the hospital). Sometimes, local hospitals have rooms set aside as hospice rooms. Depending on your need, you may stay in one or more of these places and receive hospice care.

Cost of hospice

Studies have shown that hospice care often costs less than conventional care during the last 6 months of life. Hospice care focuses on providing comfort at the end of life. In contrast to conventional care, hospices do not try to cure the illness. Hospice care does not use a lot of expensive high-cost technology. Some tests are done to make sure hospice staff are doing all they can to provide comfort, but often they stop any tests or procedures that are not going to make a significant difference in how much longer you will live. All of this reduces the cost of care.

Hospice also relies on family and friends to provide much of your daily care. Volunteers may help the family with chores or errands. Volunteers may also sit with you while your caregiver takes a short break. Using family, friends, and volunteers helps reduces the cost of care.

For more information

The rules for enrollment may be different from one hospice to another. Some programs offer prehospice counseling to people who have been diagnosed with a terminal illness. For more information about hospice or to find a hospice in your area, you can contact:

National Hospice and Palliative Care Organization

Hospice help line: 1-800-658-8898

Web site: http://www.nhpco.org