Hospice care and what patients and their families can expect

I often find, when I talk with patients and families about hospice care, there is a palpable sense of relief; relief that there is another option when facing a terminal diagnosis or end stage disease process.

Families who have participated in caring for their loved one at the end of life are grateful for the guidance provided in hospice care. Patients in turn are grateful to spend their last days at home or in a home like environment surrounded by their families. Although people frequently associate hospice with a cancer diagnosis, there are several circumstances that are appropriate for hospice care including severe cardiac disease and heart failure, Parkinson’s, Alzheimer’s and advanced pulmonary disease.

Hospice care is covered under most insurance plans including Medicare. Hospice is a comprehensive approach to patients focused on caring not curing with an emphasis on the physical, social, cultural, emotional and spiritual needs of both patient and family. Hospice is a holistic alternative to aggressive and procedure oriented medicine with the goal of comfort and relief of symptoms to improve the quality of life.

The philosophy of hospice accepts death as a natural part of life. Hospice care includes counseling services, prescriptions, medical supplies and home health aides. Additionally, caregivers are supported and assisted to care for their loved one and come to terms with the impending loss.

Upon entering hospice, an individualized plan of care is developed with an emphasis on respecting the patient’s wishes and enhancing the family’s communication. The plan is up dated as appropriate with an interdisciplinary team including physicians, nurses, therapists, a chaplain, pharmacist and nutritionist. A primary care giver will be guided to aid the patient in feeding, bathing, administering medications and supporting the patient. The hospice staff is available by phone 24 hours a day for assistance with pain and symptom control. Bereavement services are provided for families up to one year after the death offering grief and spiritual counseling.

Volunteers are an important part of the hospice experience serving to demystify the dying experience and provide a humane and personal touch for patients and families. Opportunities for volunteers include support for patients and respite care for families, bereavement care and administrative activities. Volunteers find work with hospice intellectually stimulating and meaningful.

The American Hospice Foundation summarizes their philosophy as follows “Hospice is not about dying; hospice is living each moment fully”.

Aldebra Schroll is a family physician who blogs An Apple a Day.

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  • http://www.ohioonlineinsurance.com jmb in ohio

    This can be a very trying time in a family’s life. There is no finer charity to be involved with. Giving families support and respite time is something they never forget and can often create charitable acts in return.

  • http://brucesmallsurveys.typepad.com/ Bruce Small

    We had hospice care for my mom, and everyone involved was wonderful. I have nothing but praise for the hospice workers.


    I am often amazed how quiclkly my patients die after I authorize a “comfort pack” at the request of the nurse.

    • family doc

      nah, i disagree. i used to order “comfort packs” for my patients in hopsice (half of my job is hospice care; the other half private practice). then i realized that even if i ordered the “comfort pack” i was still getting called (in the middle of the nite) for the specific directions on each component of the pack, including morphine. so i stopped ordering the pack and just ordered the individual components with dosing orders. i have not noticed a difference in times to death with or without the “comfort pack”. the average length of stay in my hospice is 19 days so maybe your patients dying quickly is just because they are already near passing when they are admitted?

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