Hospice: What is it and what kind of care does it provide?

May 26, 2021

Hospice is a scary word. 

Talking about, and suggesting Hospice can cause feelings of fear and sadness. This can be a very challenging time for the individual who is sick and their loved ones. Talking about hospice care can make people feel that there is no longer hope for recovery. 

It is true that Hospice care is available when an individual likely has less than six months to live, but it is also true that Hospice care is provided by experts. Experts who have likely cared for many individuals with the same illness and the same symptoms. During this difficult time, the Hospice team can guide you through tough decisions about treatments and Hospice services provided by experts. 

What is Hospice?

Hospice is a special kind of medical care for someone with a life-limiting illness, helping them live comfortably, and increasing their quality of life. Hospice care provides compassionate care for people in the last stages of an incurable illness so they can live as fully as possible. 

Hospice is an interdisciplinary team that addresses the physical and emotional needs of the individual and their family. A team of professionals work together to manage symptoms so that a person’s last days can be spent with dignity and quality, surrounded by those who matter most. Hospice addresses symptom management, coordination of care, communication and decision making, and clarification of goals and preferences. 

The Hospice philosophy accepts death as the final stage of life, affirming life. Hospice does not hasten nor postpone death. Hospice treats the person and their symptoms while honoring their preferences and the preferences of their family. 

Hospice offers hope, making the best of each day during the last stages of advanced illness.

What does Hospice provide? 

Palliative care, also called supportive care, symptom management, or comfort care can be provided separately or together with Hospice care. Palliative care doesn't treat the illness, but instead, it treats the symptoms and side effects of the illness. 

Palliative care gives patients options and allows them and their caregivers to work together to plan their care. The main goal of palliative care is to help patients be as comfortable as possible during their last stage of life. 

Homecare vs. Inpatient Care-Most Hospice care is centered in the home but sometimes, an in-patient facility may be necessary. This can be a temporary or a permanent solution and the patient can go back to in-home care when they choose. 

Spiritual Care-People differ in their spiritual beliefs and spiritual care depends on each person’s individual needs and desires. Spiritual care may include meeting with a spiritual leader or member of the religious community to discuss questions about life and death, prayers, or religious ceremonies. 

Family Meetings-Regularly scheduled meetings run by the hospice nurse or social worker are available to the family members to keep everyone informed and to discuss what to expect. These meetings give everyone a chance to ask questions and share feelings. Daily updates can be arranged as well. 

Coordination of Care-The team of hospice specialists coordinate and supervise care 7 days a week, 24 hours a day. The team includes the doctor, pharmacist, spiritual leaders, nurses, aides, social workers, and therapists. The hospice team can always be contacted if there is an issue, day or night. There is always someone on call to discuss whatever issue may arise. 

Respite Care-If a patient is being cared for at home, some hospice programs offer respite care. Respite care allows the family some time away from their caregiving responsibilities. Respite care can be offered for up to 5-days at a time. During this time, the patient is cared for in a facility temporarily. 

Bereavement Care-After a loss, the hospice team can work together with the surviving loved ones to help them through the grieving process. They can provide support to the family or refer them to other services including support groups. Bereavement care can be provided for up to a year after the patient passes away. 

Where is Hospice care provided?

Hospice is usually provided at home. But hospice can also be provided in a specialized facility or program in a facility. Regardless of the setting, hospice care is designed to be available 24 hours a day, 7 days a week. The doctor, social worker, or case manager can discuss with the patient and family which type of hospice program is best, based on the needs and preferences of the patient. 

Home Hospice Care-Most people choose to receive hospice care at home. If someone lives in a residential facility like assisted living, independent living, nursing homes, etc., they can receive hospice care there as well since that is the patient’s home. The primary caregiver is usually a friend or family member who takes overall responsibility for the patient and their supervision and management of their needs. The primary caregiver will be with the patient most of the time and be trained to provide most of the hands-on care.

Hospice may require that someone be home with the patient 24 hours a day, 7 days a week, for safety reasons. This must be carefully considered since the proposed primary caregiver may have a job or other obligations. This can be arranged through scheduling and teamwork between friends and family. When the patient is admitted to the hospice program, the hospice representative will visit the patient in the hospital or if they are home, they will visit them there. The primary caregiver is an integral part of organizing the care. Frequent visits from the hospice nurse can be expected, as well as some home health aide assistance, depending on insurance coverage. Nurses are available on call around the clock to answer questions and make visits if needed. 

Inpatient care-Hospice can be provided in a facility that specializes in hospice or a facility that has a hospice unit within their facility. This can be helpful for patients that don’t have a caregiver available or those that need around-the-clock care. 

How are Hospice services paid for? 

Medicare, VA benefits, and Medicaid all cover hospice services. Private insurance may also cover hospice services but coverage will vary depending on the policy. 

Starting a conversation about hospice can be upsetting and difficult. It doesn’t necessarily mean that now is the right time to start hospice care. But having a conversation with a medical professional is an opportunity to begin the discussion of what’s important to the patient and the family and how to ensure that those goals are met. Working with a team of experts who are focused on the priorities of the patient and the family is ideal. This can be accomplished with a dedicated team of hospice specialists. 

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