The philosophy of hospice is that dying is “an integral part of the life cycle.” Hospice workers allow the process of death to take its course without hastening or prolonging it. They focus on “promoting a peaceful and comfortable death. through pain relief, comfort and enhanced quality of life.” National Hospice and Palliative Care Organization
Where Can I Receive Hospice Services?
Hospice is not a place, it is a service which will come to wherever the patient is, though there are some hospice facilities with beds in some locations. Most people receive hospice services in a private home,
hospital, nursing home, or other facility. Hospice workers are available 24 hours per day, 7 days per week. Hospice’s focus on terminal patients is what distinguishes it from other types of in-home care.
To find hospice providers near you, visit HospiceDirectory.org, where you can search by zip code or province in the USA and Canada. If there is no hospice within your zip code you will see of list of hospice providers in the state in alphabetical order based on city. Choose the city nearest you; hospice usually covers wide geographic areas. Or you can look in a local phone book or ask your doctor.
Who is Eligible?
In order to qualify for hospice care, a patient must have a terminal illness as certified by a doctor, with a prognosis of six months or less to live. In addition, the family and patient must have decided that they are no longer seeking “curative treatment.” This means that there is recognition that the patient is dying, that the illness cannot be cured, and that in the event of a heart attack or other life-ending event, resuscitation, life support, and treatment will not be sought. This usually involves signing a “do not resuscitate” (DNR) order.
Once the patient signs a DNR and enlists the services of hospice, instead of calling 911 in an emergency, the family will call the hospice nurse. The nurse will arrive to administer pain medication as needed and keep the patient as comfortable as possible, as well as provide counseling, information and comfort to family members.
“Hospice also recognizes the potential for growth that often exists within the dying experience for the individual and his/her family and seeks to protect and nurture this potential.” – National Hospice and Palliative Care Organization
What Types of Services Are Available?
After visiting the patient and developing a care plan, hospice provides services such as:
- physician care
- visiting nurses
- personal care aides to assist the patient with dressing and bathing
- counseling
- information and referral
- medical equipment and supplies
- pain management and symptom control
- respite for caregivers
- nutritional counseling
- bereavement counseling and support groups for family members
How is Hospice Paid For?
Private health insurance and Medicare usually cover hospice, as does Medicaid in most states. Many hospice organizations seek private donations which enables them to offer services to those without insurance on a sliding fee scale, or for free. Hospice programs are licensed by the state they operate in.
Psychological Aspects of Securing Hospice Services
People may hesitate to secure hospice services because they have not yet accepted the fact of their loved one’s inevitable death.
Sometimes family members who live at a distance put pressure on the caregiver not to enlist hospice. They may see it as giving up rather than promoting quality of life and comfort.
Being removed from the situation, they may not understand how much the loved one’s quality of life has deteriorated, or they may not yet be able to accept that they are losing their loved one.
If your instinct is to switch from curative to palliative (hospice) care but you are not sure, you can contact hospice and simply ask for an assessment. Once you have met the hospice nurse and discussed your options and concerns, you should feel more confident in making a decision.
©Lisa C. DeLuca, all rights reserved. It is a violation of copyright law to reproduce this work on the web or for business use without permission from the author. This article was originally published on the web in 2008. Please contact the author with your reprint request.