Understanding Hospice Care

In the 1960s, Dame Cicely Saunders created and pioneered modern hospice care, thus altering the way medical practitioners treat patients with life-limiting illnesses. Summing up the philosophy of hospice care, Saunders offered, “You matter because you are you, and you matter to the last moment of your life, and we will do all we can, not only to let you die peacefully, but live until you die.” Driven by patient and family wishes, hospice services are designed to assist an individual to live life fully, comfortably, and with dignity to its end. Dame Cicely Saunders pioneered the combination of expert pain and symptom relief with holistic care, a consideration of an individual’s physical, psychological, spiritual, and social welfare that continues to guide hospice care today.

Dame Cicely Saunders’ work in England spurred the origins of hospice care in the United States in the 1970s. At first a small grassroots movement, hospice care in the U.S. experienced rapid proliferation following the creation of the Medicare Hospice Benefit through the 1982 Tax Equity and Fiscal Responsibility Act. The last decade has seen continued modernization and rapid expansion of hospice services with over 3,650 providers in the United States alone. With so many hospice providers from which to choose, it is important for an individual to understand their right to choose a hospice care provider that fits their needs.

Common Questions

What is hospice? Hospice is an idea, a concept of care, not a place. If someone you love has an incurable illness and life cannot be prolonged; comfort care includes palliative care, emotional closure, and personal peace, can be provided for you and your loved one.

When is the right time to ask about hospice? Every situation is as unique as a fingerprint, but one fact remains constant: end-of-life care is difficult to face and to discuss. However, it is helpful for family members to share their wishes with one another long before a diagnosis of terminal illness occurs. Therefore, any moment is an appropriate time to discuss hospice care wishes.

Who qualifies for hospice services? Individuals become eligible for hospice services when a physician certifies that a patient has a probability of six months or less to live.

What services should I expect from my hospice care provider? From its origins, hospice care denotes an interdisciplinary approach for the care of the individual. Physicians, nursing staff, social workers, chaplains, and volunteers all work together in providing holistic care. Hospices also offer specialized pain management services, community education, respite care for caregivers, and bereavement services for family members.

Where may a patient receive hospice services? Individuals who need and want hospice services may stay at home, with friends or relatives, in a long-term care setting, in an inpatient hospice unit, or in a hospital.

What happens if the patient survives longer than six months? Once an individual becomes a hospice patient, he continues to receive services as long as the services are needed. Services are not discontinued unless they are no longer deemed necessary or the patient chooses to have them ended.

Common Myths Regarding Hospice

Hospice is for people with cancer. Hospice providers care for patients and their families that are coping with the end-stages of chronic diseases, like emphysema, Alzheimer’s, HIV/AIDS, cardiovascular, and neuromuscular diseases as well as those living with cancer.

Hospice care is expensive. Hospice care is covered by Medicare, Medicaid, and most private insurance benefit plans. Most people who use hospice care are over age sixty-five and are entitled to the Medicare Hospice Benefit. Benefits normally cover virtually all hospice services and require little out-of-pocket costs. Most hospice care providers are willing to provide coverage regardless of the patient’s ability to pay.

Hospice is only for dying people. Hospice care is a family-centered concept of care with energy focused on the grieving family as well as the dying patient. When investigating a hospice service provider, it is helpful to examine its length of bereavement care and community education commitments.

About the Author

Elba Rivas began her career in human services in the mid 1990s but it wasn’t until she began working for United Hospice in 2004 that she found her passion. As a Community Relations Representative for the Low Country and Coastal Empire, Elba had the opportunity to promote the hospice philosophy so more people living with life-limiting illness and their families could find comfort care. Most recently, Elba was promoted to Community Relations Development Coordinator for South Carolina at United Hospice. She is a native of Beaufort, SC and loves the coastal region. The quote from Dame Cicely Saunders can be found at www.eolc-observatory.net/history/cicely.htm.