Currently, there are 40 million senior citizens in the United States, a number that is expected to double in the next 30 years, as baby boomers reach age 65. As this number increases so will the number of Americans who face hard decisions about end-of-life care. One option that can ease concerns about end-of-life treatment is hospice, which can be provided at the patient’s home, in a long-term care facility, or in a specialized unit within a hospital. In addition to offering holistic benefits for the patient, hospices – such as Hope Hospice – support family members who are dealing with a loved one’s terminal illness.
One concern voiced by many Americans is finding the best care for themselves or a loved one who has a terminal illness and less than six months to live. Hospice offers what people say that they want at the end of life – choice in care, medical attention, help for the family, spiritual and emotional support, and the option to remain in their own homes. More than 3,000 hospices now provide end-of-life care and comfort in the United States.
Hospice care should be considered when a patient has a life-limiting illness that is progressing despite standard treatments. More than half of all hospice patients have cancer; many of the rest have heart disease, pulmonary disease or Alzheimer’s disease. Palliative – or comfort – care provides physical, emotional, and spiritual support, emphasizing relief of pain and other distressing symptoms.
Hospice care is covered by Medicare, by Medicaid in 33 states and by most private insurance benefits. For the uninsured, many hospices will assist families in accessing coverage or make their services available using money raised from memorial and foundation gifts.
The decision to choose hospice care can be difficult as the patient and family need to accept the shift in focus from curative to comfort. Unfortunately, many people wait until it is almost too late to reap the holistic benefits of hospice and palliative care fully.
Hospice offers the support and encouragement that patients and families deserve during the final months of life. A team of nurses, hospice aides, physicians, spiritual advisors, social workers and trained volunteers provide the hospice care. Along with caring for patients, these individuals make home visits, provide respite for caregivers, and coordinate community services by listening and responding to the needs of the patient and family. In caring for the loved one, the hospice team recognizes that the family often knows best regarding what will make the patient comfortable. These hospice workers acknowledge the courage it takes to care for a loved one who is dying. The medical director works with the patient’s primary physician to oversee daily care whether the patient is at home, the home of a loved one or in a long-term care facility. While some hospices offer a residential hospice option, all hospice programs have inpatient hospice beds reserved at designated sites that may be used in specific medical situations for a limited duration.
Hospice provides medical equipment (hospital bed, commode, oxygen, etc) along with medical supplies and prescribed medications for pain control and symptom mangement. It also covers outpatient treatments and short-term hospital care, which may be needed when symptoms cannot be managed at home.
Hospice is unique in that it includes support for a patient’s family during the illness as well as for a year after the patient’s death. Although the disease and its symptoms happen to the patient, the illness affects the entire family. Facing illness and death as a family can help to make this time easier, though not all families can be open to share their feelings.
A loved one’s terminal illness presents a time of uncertainty and emotional vulnerability. The patient may be resigned to the reality of his or her impending death, and family members may feel angry, thinking their loved one has given up. This anger often is a result of frustration or sorrow. A family member may find it is easier to share these feelings with outside sources, such as a nurse, counselor, clergy, trusted friend or hospice team member, who can encourage family members to talk, listen, and help one another.
Children have special needs in dealing with the impending death of someone they love. Depending on their age and stage of development, death may have different meanings for children. Hospice provides help in answering children’s questions honestly at an appropriate level, and it offers bereavement programs that support the whole family in dealing with the emotional and spiritual issues of their loss.
The best time to learn about hospice is before it is needed. The earlier hospice is involved, the more it can make the patient’s final days, weeks, and months as comfortable and satisfying as possible. Many surviving family members say, “I do not know what I would have done without hospice.”