Most individuals have heard of hospice, but not everyone knows exactly what hospice is. Dame Sicely Saunders, the founder of the first modern hospice, said, “You matter because of who you are. You matter to the last moment of your life, and we will do all we can not only to help you die peacefully, but also to live until you die.” So how does hospice help you die peacefully but also help you live until you die? The hospice philosophy accepts death simply as the final stage in the journey of life. To that end, hospice affirms and celebrates life as well as the death process. The main goal of hospice is to allow the individual who is sick to die with dignity, ensuring that pain is reduced and the physical, psychological, and spiritual needs of the individual are met.
To receive hospice care, an individual is generally expected to live six months or less if the illness or disease continues to progress naturally. A hospice provider must receive a physician’s certificate confirming the individual has a terminal illness with less than 6 months to live, and a hospice care plan must be set up. Some healthcare professionals may be resistant to recommending hospice because it may appear that the healthcare professional is giving up or has even failed. Family members may also be resistant to agreeing to hospice care because they don’t want their loved one to think the family has given up. However, often, hospice care is not started soon enough. Hospice care can supply a better quality of life for the individual who needs the care and provide an opportunity for the family to obtain the support they need.
When an individual has 6 or fewer months left to live, that person often needs help. Family and friends typically step in to take care of the physical, emotional, and spiritual needs of their loved one. What exactly can hospice do to help the sick individual out? Hospice provides a range of services that are intended to meet the physical, emotional, and spiritual needs of someone with 6 or fewer months to live. This assistance can be in the form of, among other things, managing medication, providing medical supplies, administering morphine, providing social worker counseling, and providing limited help with CNA service for bathing and toileting. Hospice also provides emotional and spiritual support for not only the individual who is sick but also for that person’s family and friends to help everyone work through the normal emotional and spiritual struggles that come with facing the reality that a loved one’s time here on earth is ending.
Hospice can be provided in a variety of settings. Some individuals receive hospice support in the hospital, skilled nursing facility, or assisted living facility. Other individuals opt to be admitted to a hospice facility for 24-hour care when there are no family or friends who can meet their needs. However, most individuals who have hospice care are being cared for primarily by friends and family in the home environment. In that situation, the hospice nurses make regular visits and are available by phone 24 hours a day. It depends on the unique situation of each individual where hospice care will be provided.
As we all know, healthcare services are expensive. Hospice is covered by Medicare, the Veteran’s Administration, and sometimes Medicaid. Private insurance also covers hospice. With that said, many hospice providers will not turn someone away for lack of ability to pay. Hospice often provides reduced rates or care at no cost based on the ability to pay. Hospice providers can often do this because of donations and grants. Most hospice providers have financial support staff to help individuals and their families navigate financial options.
The American Cancer Society recommends asking the following questions when considering inpatient hospice care:
Where is such care provided?
What are the requirements for inpatient admission?
How long can a patient stay?
What happens if the patient no longer needs inpatient care but can’t go home?
Can you tour the inpatient unit or residential facility?
Which hospitals or nursing homes contract with the hospice for inpatient care?
What kind of follow-up does the hospice provide for inpatients?
Does the hospice provide as much nursing, social work, and aide care for each inpatient as it does for those at home?
Does the agency explain your rights and responsibilities as a patient? Ask to see a copy of the agency’s patient’s rights and responsibilities information.
If your loved one has been told that he or she has six months or less to live, speak to him or her about hospice care.