Hospice

Understanding Hospice Care

     "Assisted Suicide", "Hospice Care", "Euthanasia". What's the difference?  While, these three terms deal with death, that is where the similarities end. 

     Assisted suicide and euthanasia, both relate to the intentional taking of a life, normally with the individual's consent and the assistance of another individual.  While based on compassion, they are illegal in the State of Ohio. 

     Hospice care, on the other hand, is a philosophy of care oriented toward life and living in the midst of dying.  Its focus is on quality of life.  It does not add "days to a person's life, but life to a person's days."  Hospice care does not attempt to hasten death, nor prolong it. 

     Although assisted suicide and Jack Kevorkian have been covered extensively by the media in recent years, the Hospice community would like to stand up and be noticed as the best means to support individuals with a terminal disease and their families during a difficult time for everyone involved.  As a service to our community, we would like to provide an overview of hospice care. 

     Historically, hospice care in the U.S. was formally introduced in 1974 and continued to evolve until 1984 when the government recognized it as an intricate part of the continuum of care for individuals on Medicare.  Since that time, the majority of insurance companies have developed programs that include hospice services as an aspect of care for their subscribers. 

     In its broadest sense, hospice care is a holistic approach providing care to the terminally ill and is the last step on the health care delivery continuum.  Ideally, when someone is first diagnosed with an illness, the hope is that the individual can be cured.  If a cure is not achievable, the hope is that the illness can be controlled.  When that is not possible, the focus becomes comfort care -- the type of care that hospices are all about. 

     Hospice care is a medically directed and nurse coordinated service provided through an Interdisciplinary team.  In addition to doctors and nurses, the hospice team is made up of social workers, home health aides, chaplains, grief services coordinators, therapists, dieticians, palliative pharmacists, long-term care providers, medical equipment specialists, volunteers and clerical support.  With hospice focusing on comfort care and not cure, the care provided concentrates on pain and symptom management of the patient.  It also evaluates the spiritual and emotional aspects of the individual and their significant others.  Although the individual is terminal, the goal is to add life to their remaining days.

     A key goal of the hospice team is to help the patient and their family identify what is necessary for the individual to die at peace with their life.  This may involve planning a last trip, reminiscing about the past, resolving bad feelings amongst family members or gathering everyone to say a last goodbye. 

     Hospice care can be a positive experience during a difficult time.  Although many people have a general understanding about it, there are a few common myths about hospice care.  One myth being that only cancer patients are eligible for services.  The truth is that anyone who has a terminal or chronic disease with a projected life expectancy of 6 months or less and not receiving a curative treatment is eligible.  A second myth is that services can only be obtained just prior to death.  In reality, the sooner the individual is referred the better.  The hospice team can be the most effective and useful when given the time to address the needs of the patient and family.  A third myth is that only a doctor can make a referral to hospice.  Anyone, including the patient or their family, can call the hospice program.  The hospice staff will then call the individual's doctor to verify the terminal status and obtain orders for care.  A fourth myth, and a frequent obstacle to care, is that services will only be provided if the individual has insurance or is able to pay.  The Hospice programs of Hospice & Health Services, Inc., like most hospice programs, never turn anyone away related to their inability to pay.  The level of care provided is the same for all patients.  The cost of care for those unable to pay is paid by donations to the hospice program.  Hospice programs rely heavily on community support to carry out their mission.

     A unique and little known fact about hospice care is its grief services component.  The focus of this service is to help support the individuals of all ages left behind after a death.  Through the grief services program, the significant others of the deceased are contacted routinely for 13 months following the death to help them work through their grief.  The contacts can range from phone calls to letters to visits to being part of a grief support group. 

     Hospice care is a unique approach to care during a routine, but difficult, part of our journey through life.