Hospice is a special concept of care, focused on providing comfort, relieving pain, and offering support for persons with life-limiting health conditions and their families. Hospice provides pain and symptom relief, as well as emotional and spiritual support, typically in the last six months of life.
Hospice care occurs wherever a person calls home. Hospice is not a “place”; patients receive hospice care at home, and home is broadly defined. Home may be a person’s residence, a nursing home or an assisted living facility, or a residential hospice.
Hospice is open to people of all ages, including children, and to people who have different medical conditions. While approximately two out of three hospice patients are over the age of 65, hospice care is available across the lifespan. Hospice treats patients with Alzheimer’s disease, cancer, heart disease, lung disease, neurological diseases, HIV/AIDS, and other end-of-life conditions.
Hospice services are available on-call 24 hours a day, 7 days a week. In addition to regular visits from the hospice team, families can reach hospice professionals any time with questions and concerns, and a hospice team member is available for medical and other crises.
Hospice professionals are committed to bringing pain under control as quickly as possible. Needless pain and suffering can bring unnecessary anguish to individuals who are dying and the loved ones caring for them.
Many families who have been served by hospice wish that they had taken advantage of hospice services sooner. Although hospice coverage is intended for patients with six months or less to live, the majority of patients spend far less than six months under hospice care, which makes it difficult to take full advantage of hospice’s ability to make a patient’s last days more peaceful and comfortable.
Hospice staff is often present at a patient’s death and is usually closely involved as death approaches. This is one of hospice’s greatest abilities, and can be one of the gifts that this care brings—helping the patient and his or her loved ones cope and understand what is happening as a person is dying.
The costs of hospice care are generally covered under Medicare. The Medicare Hospice Benefit covers the range of clinical and supportive services—meaning psychological, emotional and spiritual services that are deemed “reasonable and necessary” by Medicare for managing a person’s illness. Most state Medicaid programs offer hospice coverage, as do most private health insurance plans.
Hospice care is available to patients for as long as the patient needs care. As long as a physician certifies that the patient continues to meet guidelines for receiving hospice care, hospice is available in an unlimited number of 60-day periods.
Hospice Provides What Americans Want At the End of Life
The hospice philosophy holds that end-of-life care should emphasize quality of life. A nationwide Gallup survey conducted for the National Hospice and Palliative Care Organization produced five key outcomes:
Nine out of ten adults would prefer to be cared for at home rather than in a hospital or nursing home if diagnosed with a terminal illness. Hospice does provide the option of being cared for at a place the patient calls home. 96% of hospice care is provided in the patient’s home or place they call home.
An overwhelming majority of adults said they would be interested in the comprehensive program of care at home that hospice programs provide. Yet most Americans know little or nothing about their eligibility for or the availability of hospice in their area.
When asked to name their greatest fears associated with death, respondents most cited “being a burden to family and friends,” followed by “pain” and “lack of control.” Addressing the whole range of physical and psychological needs of the patient and his or her family in an interdisciplinary way is what makes hospice so special.
90% of adults believe it is the family’s responsibility to care for the dying. Hospice provides families with the support needed to keep their loved one at home, and can take over fully to give the caretaker short “respite” periods.
Most adults believe it would take a year or more to adjust to the death of a loved one. However, only 10% of adults have ever participated in a bereavement program or grief counseling following the death of a loved one. Hospice programs offer one year of grief counseling and support for the surviving family and friends.