Hospice is a model of care that focuses on providing physical and emotional comfort to people who are dying, and on supporting their families, during the end-‐of-‐life period. Several core principles form the basis for the hospice philosophy, including:
Hospice provides palliative care (that is, care that will make you more comfortable but will not prolong your life) in addition to services such as counseling, respite, and bereavement care (support for your family after your death). Hospice care is delivered by an interdisciplinary team of doctors, nurses, home health aides, certified nursing assistants, counselors, social workers, religious or spiritual leaders, and volunteers. Hospice care comes to the client, wherever the client is. Many people choose to receive hospice care in their homes, but it can also be provided in settings such as long-term care facilities, hospice facilities, and hospitals. Hospice services are available 24 hours a day, 7 days a week.
Many people think accepting hospice care is “giving up,” but in fact, hospice care does not hasten death. It simply seeks to improve quality of life during the end-‐of-‐life period. Although it can be tempting to put off hospice until you “really need it,” you can derive the most benefit from hospice services when you start them sooner, rather than later. Timely admission into a hospice program allows the hospice team to fully evaluate your family’s needs and develop an appropriate care plan. In addition, the regular visits from the hospice nurse and other team members help the hospice team to anticipate needs and intervene before a crisis situation develops. It is important to understand that entering a hospice program does not mean that you have to stay— you can discontinue hospice services at any time.
Signs that it might be time to initiate a discussion about a hospice referral with your doctor may include the following.
Before you need hospice services, you may want to research hospice providers in your community. Both the National Hospice and Palliative Care Organization (NHPCO) and the National Association for Home Care & Hospice (NAHC) offer hospice locator tools on their websites. Once you have a short list of candidates, gather additional information that will help you gauge whether or not the hospice is a good fit. In addition to standard questions (for example about Medicare certification, licensure, accreditation, and quality assurance), here are some questions you may want to ask:
Hospice care is covered by Medicare, Medicaid (in most states), the Veterans Health Administration, and most private insurance plans. If you must pay out of pocket for hospice care, you should be eligible for financial assistance. Donations, grants, and memorial funds allow many hospice providers to provide services at a reduced cost or no cost to families in financial need.
Bibliography
“Choosing a Hospice: 16 Questions to Ask.” American Hospice Foundation. www.americanhospice.org/learning-‐about-‐ hospice/choosing-‐a-‐hospice-‐16-‐questions-‐to-‐ask/.
“Choosing a Quality Hospice for You or Your Loved Ones.” National Hospice and Palliative Care Organization, 2014. www.moments.nhpco.org/sites/default/files/public/moments/Choosing%20a%20Hospice.pdf.
“Hospice Care.” American Cancer Society, April 8, 2014. www.cancer.org/acs/groups/cid/documents/webcontent/002868-‐ pdf.
“Hospice Care: A Consumer’s Guide to Choosing a Hospice Program.” National Hospice and Palliative Care Organization, 2009. www.caringinfo.org/files/public/brochures/Hospice_Care.pdf.
“Not Gloom and Doom: Demystifying Hospice.” B. Norman. MDS/ALS Newsmagazine. January–February 2010, vol. 15, no. 1. “The Patient’s Guide.” ALS Maine Collaborative, 2016. www.alsmaine.org/patients-‐guide/#Erasing.