Hospice care: Comforting the terminally ill

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Hospice care: Comforting the terminally ill

If you or a loved one has a terminal illness and you've exhausted all treatment options, you may consider hospice care. Find out how hospice care works and how it can provide comfort and support to you or your loved one, as well as your family and friends.

What is hospice care?

Hospice care is intended for people who are nearing the end of life. Hospice care services are provided by a team of health care professionals who maximize comfort for a terminally ill person by reducing pain and addressing physical, psychological, social and spiritual needs. Unlike other medical care, however, the focus of hospice care isn't to cure or treat the underlying disease. The goal of hospice care is to provide the highest quality of life possible for whatever time remains.

Who can benefit from hospice care?

Hospice care is for a terminally ill person who's expected to have six months or less to live. This doesn't mean that hospice care will be provided only for six months, however. Hospice care can be provided as long as the person's doctor and hospice care team certify that the condition remains life-limiting. Many people who receive hospice care have cancer, while others may have conditions such as heart disease, dementia or chronic obstructive pulmonary disease. Enrolling in hospice care early may help you or your loved one develop a strong relationship with the hospice staff, who can help with preparation for end-of-life needs.

Where is hospice care provided?

Most hospice care is provided at home — with a family member typically serving as the primary caregiver. However, hospice care is also available at hospitals, nursing homes and dedicated hospice facilities.

Keep in mind that no matter where hospice care is provided, sometimes it's necessary to be admitted to a hospital. For instance, if a symptom can't be adequately managed by the hospice care team in a home setting, a hospital stay may be needed.

Who's involved in hospice care?

If you're not receiving hospice care at a dedicated facility, members of the hospice staff will make regular visits to your home or other setting to provide care and other services. A hospice care team typically includes:

  • Doctors. A primary care doctor and the hospice program's medical director — who typically has expertise in symptom management and end-of-life care — will oversee your or your loved one's care.
  • Nurses. Nurses will come to your or your loved one's home or other setting to provide care. Nurses also address symptom management and concerns about end-of-life issues, as well as provide support for loved ones.
  • Home health aides. Home health aides can provide extra support for routine care, such as dressing, bathing and eating.
  • Spiritual counselors. Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family.
  • Social workers. Social workers provide counseling and support. They can also help you address insurance and financial concerns.
  • Volunteers. Trained hospice volunteers offer a variety of services depending on your needs, from providing company or respite for caregivers to helping with transportation or other practical needs.
  • Bereavement counselors. Trained bereavement counselors offer support and guidance before and up to one year after the death of a loved one in hospice.

How is hospice care financed?

Medicare, Medicaid, the Department of Veterans Affairs and private insurance may pay for hospice care. While each hospice program has its own policy regarding payment for care, services are often offered based on need rather than the ability to pay. Be sure to ask about payment options before choosing a hospice program.

How do I select a hospice program?

To find out about hospice programs, talk to doctors, nurses, social workers or counselors, or contact your local or state office on aging. Consider asking friends or neighbors for advice. The National Hospice and Palliative Care Organization also offers an online provider directory.

To evaluate a hospice program, ask questions about the services offered. For example:

  • Is the hospice program Medicare-certified? Is the program reviewed and licensed by the state or certified in some other way?
  • What services are offered to a terminally ill person?
  • How are pain and other symptoms managed?
  • Who makes up the hospice care team, and how are they trained or screened?
  • How are hospice care services provided after hours?
  • How long does it take to get accepted into the hospice care program?
  • What services are offered to the family?
  • What respite services are available for the caregiver?
  • What bereavement services are available?
  • If circumstances change, can services be provided in different settings? Does the hospice have contracts with local nursing homes? Is residential hospice available?
  • Are hospice costs covered by insurance or other sources, such as Medicare?

Remember, hospice stresses care over cure. The goal is to provide comfort during the final months and days of life.

Last Updated: 2010-04-16
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