Also known as end-of-life care, hospice care is treatment for patients who have terminal illnesses. The goals of hospice care are to treat the patient, not the disease, and to help the patient live out the rest of his or her life as fully, as comfortably, and as pain-free as possible. Hospice care is guided by the belief that death is an acceptable last stage of life and that people who are dying deserve comfort, dignity, and respect.
Hospice care is provided by a team of medical, mental health, and social work professionals along with support staff. It may be given in a hospice center, in a hospital, or in the home. Choosing high-quality hospice care for a loved one is important, because it is this care that will make the end of their life comfortable. The caregivers also support the family as they cope with the grief of losing a loved one.
What is Hospice Care?
Hospice care is compassionate care for patients who are terminally ill. The goals are to help patients feel comfortable for what time is left in their lives and to help them live their lives as fully as is possible. The philosophy of hospice care is based on the idea that death is a stage of life, the final stage, and that it should be accepted and treated with dignity. Unlike curative care or treatment for a disease, hospice services treat the patient, not the illness the patient has. Hospice care can be administered in the home or in a residential setting, usually a facility or department dedicated to hospice patients.
Who Needs Hospice Care?
Anyone who has a terminal illness, who has approximately six months or less to live, and whose illness can no longer get better with curative treatments is a good candidate for hospice care. For insurance purposes, most plans require that a doctor or nurse practitioner certify that a patient has about six months to live if the terminal illness were to run its course. This can be extended and patients can continue in hospice care beyond six months if a doctor recertifies the patient.
Deciding when the time is right for someone to receive hospice care is challenging. More often than not, people go into hospice care later than they should. This is because choosing hospice can feel like giving up on the patient. When curative treatments are no longer helping, a doctor believes the patient has less than six months to live, and the patient is struggling with pain and is not very independent it may be the right time for hospice care. However, the decision is highly personal and individual.
The people who provide hospice care make up a team of dedicated professionals, and most of them specialize in this kind of care. The team includes doctors, nurses and nurse practitioners, social workers, therapists and counselors, spiritual guides or chaplains, physical therapists, occupational therapists, pharmacists, aides, and assistants. Hospice centers may also have volunteers. While most hospice plans include a resident doctor, patients are encouraged to include their regular doctors on the team as well.
Services Provided in Hospice Care
The over-arching goal of hospice care is to improve quality of life, which may mean different things to each individual. Good quality hospice care puts the patient’s needs and goals first. In general, controlling pain and other symptoms that help make the patient physically more comfortable is a major goal of hospice care. Care may address pain, nausea, joint mobility, and other side effects of an illness while also helping the patient to remain alert and aware. Other services offered in hospice care include:
- Counseling for coming to terms with dying and management of other mental and emotional symptoms of being terminally ill.
- Providing and administering all medical care needs, such as medication, fluids, and breathing support.
- Spiritual care and guidance.
- Providing alternative and supportive therapies, such as physical therapy, acupuncture, massage, art therapy, and others.
- Coordinating and supervising all aspects of a patient’s care, and planning for end-stage care.
- Supporting loved ones and helping them learn how to care for and support their dying family member.
- Bereavement support and counseling for loved ones.
- Respite care for caregivers who take care of their loved ones at home.
In-Home vs. Residential Hospice Care
Hospice care can be administered from the home, with a support team on call 24 hours a day and with professionals and aids coming to the home to support the patient. It can also be care that is provided in a dedicated hospice facility or in a hospice unit within a hospital or other care facility. Many hospitals and hospice centers also provide temporary inpatient care to provide respite for home caregivers.
Choosing in-home or residential hospice care depends on a few factors, and to the extent possible, it should be the choice of the patient. Many people want to live out their final days at home, and this can be done for many. Hospice care can be provided on an in-home basis, but for some patients it isn’t possible. There may not be anyone in the family who can care for a dying patient around the clock, even with hospice care. In these situations, residential care may be best.
Choosing Hospice Care
Hospice care is among the most important types of care a person will receive because it allows them to die with dignity and in comfort. Choosing a quality care team for a loved one is a big decision. Before you select a facility or an in-home service, make sure you do the research. Look for hospice care agencies that are certified or licensed by the state or nationally accredited by the Joint Commission.
In addition to these formal checks on quality, be sure to ask a lot of questions about the care your loved one will receive before you make your choice. Find out who will be on the care team and what their qualifications are, what services are provided, that at least one team member will be available 24 hours a day for emergencies, if the team meets regularly with the family to discuss services and care, and how much the team takes the patient’s wishes into account when providing services.
All types of care should be of the highest quality and meet the highest standards, but with hospice care the stakes are high. It is a complicated type of care with many different elements and a lot of different professionals involved. It is highly emotional, for the patients and their loved ones. People with terminal illnesses deserve to have the best care, and for family members, finding the highest quality hospice care is of the utmost importance.