Hospice isn’t a place. It’s a type of care that focuses on living…living as fully as possible, up until the end of life. Hospice brings comfort, love, and respect to the patients and families they care for.

Considered to be the model for high-quality, compassionate care at the end of life, hospice care involves a team-oriented approach to care that includes expert medical care, pain-and-symptom management, and emotional and spiritual support. All care is expressly tailored to the patient’s needs and wishes.

Hospice offers the services and support that Americans want when coping with a serious or life-limiting illness.

The goal of this type of care is to treat the person instead of the disease, and focus on the family caregivers, not just the individual.  The quality of life is emphasized, not its duration.

Just the Facts: National Hospice and Palliative Care Organization reports:

Hospice usage in the U.S. is growing. Every year, more than 1.65 million Americans with life-limiting illness are cared for by the nation’s 5,100 hospice providers.

• The median length of service for hospice patients is 19.1 days (half of patients receive care for more days, half of patients receive care for fewer days).   Yet, more than 35 percent of patients die or are discharged in seven days or less – too short a time to benefit from the full ranges of services a hospice can offer.
  
•  Cancer accounts for less than 38 percent of hospice patients – which surprises many people who mistakenly think hospice only serves cancer patients. The five other leading diagnoses are: heart disease, debility, dementia (this includes Alzheimer’s disease), lung disease, and stroke.
  
• Hospice is covered under Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations.
  
• An estimated 450,000 trained volunteers contribute more than 21 million hours of service every year.
  
• Research shows that 8 out of 10 Americans would want to stay in their homes surrounded by family and loved ones if they were faced with a life-limiting illness. Hospice makes this happen.

For more information, please contact Emanuel Hospice at 616.719.0919, or email us at info@emmanuelhospice.org.  You can also call the NHPCO HelpLine at 800-658-8898, or visit www.caringinfo.org.

Hospice and palliative care both offer compassionate care to patients with serious illnesses, but they are not interchangeable. Palliative is always a component of hospice care, but palliative care is also a separate specialty.

Definitions
Palliative care focuses on relieving symptoms associated with the patient’s condition, for example pain, nausea and constipation. Hospice takes a holistic approach and addresses the patient’s physical, emotional and spiritual needs.

Timing
Hospice is reserved for terminally ill patients when treatment is no longer curative. Patients can receive palliative care while they continue to undergo active treatment for their condition.

Treatment
While in hospice, patients receive medications necessary to relieve pain and other symptoms, but they do not receive treatment for their condition. Patients may continue to receive regular treatment while receiving palliative care.

Prognosis
Patients enter hospice when they have a life expectancy of 6 months or less. Patients with serious illnesses may receive palliative care at any time, regardless of their prognosis, according to the American Cancer Society.

Emotional Care
Palliative care focuses on making the patient comfortable. Hospice, as part of treating the whole patient, also offers mental health and spiritual counseling. Hospice also offers counseling and bereavement services for family members.

The time to begin hospice care is a difficult and personal choice. Hospice care often involves an individual or family choosing to decline receiving further treatments that might cure an individual and instead begin focusing on making a person comfortable and as pain-free as possible. The right time to start hospice care is something only a family and an individual can determine. Although doctors and health-care professionals might give advice, the decision is ultimately not up to them.

Considerations
Although people often put off hospice care until the final few weeks or days of care, there are advantages that can be gained from using hospice care earlier.

For example, a patient who enters hospice care earlier has the opportunity to make use of the pain and symptom management practices that hospice care can offer.

Similarly, a family that chooses hospice care for a loved one is able to transfer some of the responsibility for day-to-day care to the hospice team instead of doing it themselves. This allows the family to focus more on enjoying time with the patient than on caring for the patient.

This does not mean that you cannot do some of the things to care for a loved one that you have previously done. If you and the hospice patient have a certain activity or exercise that you do to bond, there are things that can still be done together. Simply let the hospice care team know what these activities are. Comfort is at the core of hospice care. Hospice care teams will work to make sure that both families and patients are comfortable with the delegation of duties.

An earlier decision to elect for hospice care can also be advantageous because it allows the family and the patient more time to become comfortable with a hospice care worker. The better a family and a patient knows a hospice care worker, the more comfortable the patient will be when he ultimately reaches his final few days. Having this initial relationship is also advantageous because everybody is more comfortable with one another when more intimate and intensive care is needed from the hospice staff.

Time Limits
In general, there is a six-month rule for people to use hospice care. This rule states that those who are terminally ill and are expected to live for six months or less are welcomed into hospices. One of the main reasons for the six-month rule is because Medicare has set this as a timetable for which it and other insurers cover hospice care.

There are situations when a person’s condition starts to deteriorate quickly in which people can be allowed into hospice programs more quickly. Once a person is admitted into hospice, he can stay until the time of death–even if death ultimately doesn’t come until years after being admitted. Patients who get better while in hospice can leave hospice care if they choose.

Hospices offer end-of-life care for patients suffering from terminal disease or advanced age. Providing patient and family support, hospices look after individuals in their home or in a hospice facility, where they receive care from nurses, staff and volunteers.
General Services

• Hospice provides general services that include medical care, therapy and daily task assistance. Nurses give direct medical care to all hospice patients and act as liaisons between patients and their primary physicians. Psychologists and other trained staff assist with speech, occupational or other forms of therapy for the patients. Individuals also may receive daily task assistance from volunteers and staff, including bathing, dressing and eating.

In-home Care

• Some patients reaching the end of their life choose to stay at home rather than enter a facility or hospital, and enlist the assistance of a hospice nurse to provide care as needed. While nurses may follow a set visitation schedule, they are available on a 24-hour basis in case of emergency or other need. If a patient’s situation worsens or the family is unable to provide adequate support, hospice offers temporary care and patient housing within a hospice facility.

Facility Care

• Nurses in hospice facilities care directly for each patient on a 24-hour basis. They monitor vital signs, provide medications and alert family members to changes in care as well as the patient’s condition and recommended treatment. They also act as a liaison between the patient’s primary physician and the family. Physicians visit hospice facilities as needed or on a schedule. Volunteers assist the hospice nurses in providing company for the patients, assisting with home care or providing professional services as needed.

Family and Loved Ones Support

• Not only does hospice provide support service for the terminally ill or others reaching the end of their life, but it also supports and cares for family and friends. For example, hospice offers bereavement and grief counseling for those affected by the loss of a loved one. This includes psychologist or volunteer meetings, in-home checkups on a grieving individual, or occasional phone calls or emails to ensure the individual copes with the loss in a healthy manner. In some cases, social workers evaluate a patient’s case to determine the best living scenario depending on family dynamics or financial situation.