Hospice is a national arm of medicine that provides care to those people and their families who are at the end of their lifespan. The word “hospice” means many things to different people. For some, it is the end of the road and place where people go to die. For others, it is a place where families and those who are terminally ill come together to face the challenges of dying so that the last months of a person’s life is positive, full of respect, free of pain, and rich in dignity. Hospice is all of those things and more.
What is Hospice?
Hospice is a different approach to health and caring for people. It addresses not only the patient but also their entire family. It does so through a network of healthcare professionals that includes doctors, nurses, social workers, chaplain, volunteers, and caregivers.
Hospice does not treat the illness of the person who is terminal. Instead, they provide a type of care that is all about compassion. They make sure that your physical, emotional, and spiritual needs are met and they do so without judgment or bias, especially when it comes to spiritual care. The goal of hospice is to provide the person who is terminal with a dignified end-of-life level of care that helps address pain management, social needs and removes as many as the burdens that people face in the last months of their lives.
A hospice is a team and as such, each patient receives a team approach and specialized care from each member of the team. The Chaplain is there to listen and not preach and in many hospices, patients can find access to a chaplain of their faith – whatever that faith might be, including those people who do not prescribe to religion.
Is Hospice the Same as Palliative Care?
While hospice and palliative care are similar, they are also very different. One way that these two important arms of health care differ is in how they treat illnesses.
With palliative care, the patient is free to aggressively treat their illness, even if those means include clinical trials and experimental medicine. With hospice, there is no treatment for terminal illness, rather they provide comfort care and respite throughout the last stages of the person’s life.
Palliative and hospice care are similar in that they both focus on the quality of life, pain management, and dignity. Both types of healthcare are team oriented and palliative care, like hospice, uses a team of professionals to address the needs of each patient.
Many hospices use a palliative care approach as both hospice and palliative care focus on the quality of life on a daily basis and both strive to make sure that people under their care have the highest quality of life possible.
Is Hospice the Same as Comfort Care?
Yes, and no. Certainly, comfort care and hospice are similar and both focus on making sure that the person receiving care is comfortable, pain free, and that they have a high level of dignity.
There can be differences and those differences are subtle. Under comfort care, the patient might still opt to treat their illness aggressively. One of the criteria for being admitted to hospice care is that a doctor must guesstimate that the patient has six months or less to live. We say “guesstimate” because nobody really can say with accuracy when another person will pass on naturally. With comfort care, you can begin to work on the issues that the patient faces long before they are eligible for Hospice. These steps include making sure that financial, personal, and legal loose ends are cleared up, that the patient is free of the burdens that they might face at the end of their lives.
In some instances, hospice is referred to as comfort care, but in reality, hospice does a lot more and offers many resources that may not be part of a non-hospice comfort care approach.
When is Hospice A Consideration?
Any time that a person has a terminal illness, hospice should be a consideration. Here, we ask a question that helps you determine when hospice is a consideration:
Are you ready to give up treatment and allow the disease to progress naturally?
If your answer is yes, then now is the time to consider hospice care. Hospice does not treat illnesses, though they will offer palliative care (comfort care) in order to reduce pain, anxiety, and help you address end-of-life concerns.
If your answer is no, then now is not the time to consider hospice. As mentioned, hospice will not treat your illness. You can opt for a non-hospice version of palliative care, which will offer you many of the same qualities of hospice care while still allowing you to treat your illness.
Have You Talked to Your Doctor About Hospice?
There are specific criteria for being admitted to hospice. One is that you must have a terminal illness. Another is that your doctor must guesstimate that you are in the last six months of your life. That is not to say you cannot live longer than six months. In fact, many people do. When that happens, you are readmitted to hospice for another six months.
Hospice is covered by Medicare Part A and through some private insurance plans. Those plans might have additional requirements too.
Is There More Than One Type of Hospice?
No. Hospice is hospice; however, the location of where you receive hospice care can vary. Most patients on hospice receive care in their homes. This is called in-home hospice care. In some situations, the patient might be admitted to a nursing home under hospice care, or be a resident in a nursing home and receive hospice care. Being admitted to a hospital under hospice care is usually because of pain management. Some treatments need a hospital setting.
If your home is a nursing home and you require hospice service, then you are admitted to hospice and they take over the bulk of your care. Hospices have agreements with nursing homes so that the transition of care is smooth and the duty of care is outlined clearly – for all involved.
What Type of Care Does Hospice Provide?
Hospice provides many levels of care and types of care, such as:
- Physical Care – provided by RN’s, LVN, Home Health Aids, and Volunteers. Includes pain management, meal and nutritional care, personal care and grooming, and therapies, such as physical therapy, occupational therapy, speech therapy, and more.
- Emotional Care – Patients on hospice receive care from social workers, therapists, and if needed, even from psychologists. They are skilled professionals that help the entire family with grief counseling and provide ongoing support to the family for six months after the patient’s passing.
- Spiritual Care – There is always a chaplain on staff and many hospices have a network of spiritual care people, often priests and clergy from many religions and denominations. People on hospice have access to the level of spiritual care they need or want, even if they are agnostic.
- Daily Living Care – Volunteers or Home Health Aids are generally available to help with things like housework, driving the patient to an appointment, etc.
Hospice works to cover every basis of care that a person can need. Each patient has a caseworker who is an RN, a social worker who is consistent, and a chaplain. These three professionals work together to cover all of the needs the patient might have. They work with families and the patient to make sure that all levels of care are appropriate, dispensed with dignity, and comes with an improvement in the quality of life for the patient and the family.
What is the Cost of Hospice Care?
Generally, the cost is covered by Medicare Part A and Part B and there is usually no co-pay that the patient must pay. In some cases, a $5 co-pay is charged per prescription, though usually Medicare and the Hospice find drugs that are approved. For inpatient respite care, the cost is 5% of the Approved Medicare Amount – this varies by state.
If you need care that is outside of hospice, such as palliative treatment, Medicare might cover those costs.
Finding a Hospice Near Me?
If you require hospice care or if you would like more information about the types of hospice providers near you, you can search online, check with your primary care doctor, or search on quality websites for options within your zip code. Sites like SeniorLiving.org not only can show you hospice organizations in your area, but often they have ratings, complaints, and feedback available from families who have used those services.
Resources for finding a Hospice near you include:
National Hospice and Palliative Care Organization
Medicare – Finding a Hospice Agency
