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 is a unique type of care program dedicated to providing comfort and support to patients and their families when a terminal illness no longer responds to treatments designed to cure illnesses/disease or when the patient/family has decided not to seek aggressive treatment anymore.
The goal of hospice is to improve the quality of life during those final days, providing comfort care and support, utilizing a team of dedicated professionals that are specially trained to deal with end of life situations. Hospice care is not intended to extend life, nor is it intended to hasten death. Hospice offers a specialized knowledge of all aspects of medical care with a primary focus on pain management.
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. The hospice staff is team-oriented, utilizing trained professionals, volunteers and family members to help deal with the emotional, social and spiritual impact of the disease on the patient, their family and friends. The team consists of registered nurses, licensed practical nurses, medical social workers, chaplains, home health aides, volunteers, support staff, and the patient’s family members and friends.
Patients are 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 program.
Myths and Facts about Hospice
Myth: Hospice is where you go when there is “nothing else to be done.”
Reality: Hospice is the “something more” that can be done for the patient and the family when the illness cannot be cured. It is a concept based on comfort-oriented care. Referral into hospice is a movement into another mode of therapy, which may be more appropriate for terminal care.
Myth: Families should be isolated from a dying patient.
Reality: Hospice staff believes that when family members (including children) experience the dying process in a caring environment, it helps counteract the fear of their own mortality and the mortality of their loved one.
Myth: Hospice care is more expensive.
Reality: Studies have shown hospice care to be no more costly. Frequently it is less expensive than conventional care during the last six months of life. Less high-cost technology is used, and family, friends, and volunteers provide 90% of the day-to-day patient care at home.
Additionally, patients eligible for Medicare or Medicaid will pay few out of pocket expenses related to their hospice care. Most private insurers also cover some or most hospice related expenses.
Myth: You can’t keep your own doctor if you enter hospice.
Reality: Hospice physicians work closely with your doctor of choice to determine a plan of care.
Hospice care is a covered benefit under Medicare for patients with a prognosis of six months or less. A patient can remain in hospice care beyond six months if a physician re-certifies that the patient is terminally ill. The hospice staff meets with both the patient and their family to discuss the hospice philosophy, available services and expectations.
Prior to service, staff and patients also discuss pain and comfort levels, support systems, financial and insurance resources, medications and equipment needs. A “plan of care” is developed for the patient. This plan is regularly reviewed and revised according to patient condition.
Bereavement services and counseling are typically available to loved ones for at least one year after the patient’s death. Many hospices offer bereavement groups that are ongoing for those that need continued support.
Information found at Hospice Foundation of America website http://www.hospicefoundation.org/pages/page.asp?page_id=47055