Hospice is a term used to describe support and care given to patients in the final stages of a terminal illness. Although the term sometimes relates to an on-site care home, hospice can refer to end-of-life caregiving services, as well as any location that care is taking place, including care in the home of the patient/loved one or a hospital.
Jump To Page Contents
- What Is Hospice Care?
- How Does Hospice Work?
- Brief History of Hospice
- Hospice Definition Medical
- Hospice Home Care – What to Expect
- What Are Typical Hospice Services
- When to Call a Hospice
- Hospice Care At Home
- Palliative Care Vs Hospice
- Comfort Care Vs Hospice
- How Long Is Hospice?
- Hospice Qualifications, Requirements and Eligibility
- What Does a Hospice Nurse Do?
- Does Medicare Cover Hospice?
- Hospice Grief Counseling
- Hospice for Alzheimers
- The Hospice Care of Aretha Franklin
- Other Related Pages
What Is Hospice Care?
The focus of hospice care is on comfort and relief from symptoms rather than finding a cure for the patient’s illness. The goal is to help the patient live each day as fully as possible, while doing what they can to maintain the patient’s dignity and attend to their emotional and spiritual needs.
What is the difference between palliative care and hospice? Many people find themselves confused about how palliative care and hospice care differ. Although it does often serve people with life-threatening illnesses, palliative care can begin at any stage of the disease including as early as the initial diagnosis. Hospice care, however, starts after treatment has stopped and when it has become apparent the patient is not going to survive the illness.
Whether a care recipient receives hospice versus palliative care is therefore usually dependent on whether the patient is still receiving treatment for their condition and their prognosis.
Many of those suffering with a terminal illness and reaching the end stage of their life, may prefer to be at home when they receive their hospice care. Hospice care at home is often similar to hospice care delivered at an inpatient facility.
Hospice nurses and home health aides along with other professionals can deliver support in the patient’s home, including medication adjustments, information and advice for the patient and their loved ones.
Yes, Medicare will pay for hospice care for patients who have Medicare Part A (Hospital Insurance) or Part C (Medicare Advantage Plans) and meet the following conditions:
- The person’s physician and hospice medical director must certify that he or she is terminally ill (e.g., life expectancy is six months or less, should the illness runs its normal course).
- They have accepted no more treatment to cure – You are accepting hospice care instead of treatment focused on curing your terminal illness
- They sign a statement to say you are choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.
- The person (or the person’s surrogate) chooses to receive hospice care and also waives the right for Medicare to pay for any other services to treat the terminal illness.
Find out more about Medicare’s eligibility requirements for hospice care.
A hospice nurse is a nurse that focuses on care at the end-of-life and is trained to provide care to terminally ill patients. They provide:
- Act as case manager/ advocate for patients and their loved ones
- Assist family members in providing practical care for the patient
- Offer emotional support to patients and families
- Administer medication and other pain relief measures
- Source of communication between interdisciplinary team.
- Frequent check-ins with the patient to evaluate their condition and needs.
- Help with paperwork for patient/family
- Educate patients’ loved ones on techniques for coping/provide comfort and support
The right care is important. If your asking the question – ‘what does a hospice nurse do?’ make sure you fully understand what is being offered and don’t hesitate to discuss this with the provider you are considering, who can give you more specific or personalized information about what tasks may be involved.
Although the typical process for each hospice care situation will vary, most patients and their caregivers can expect the following:
- A hospice referral is made by the patient’s physician or similar medical professional or the hospice is contacted directly.
- The site of care is decided via a discussion between the patient, health professionals and
- Consent in obtained from the patient, or from the person this responsibility has been delegated to.
- An individualized care plan will be developed based on the patient’s unique needs – The patient’s physician, nurse or occupational therapist often play a role in this.
- Physical aides required for the patient’s comfort including adjustable beds and lofting apparatus will be sourced.
- Caregiver support will be provided – Depending on the situation, help in caring might be offered to loved ones, including advice on how to administer medication such as injections. Psychological support is also often offered to those in a caring role.
- Continued reassessment – The patient’s needs are continually assessed to determine support needed, both physical and psychological.
There is no exact list of services every hospice patient will receive, and similarly there are no limits to the type and form of care they can be given. However, some common hospice services include:
- Medical and nursing support
- Equipment and medical supplies
- hospice aide/homemaker services
- social worker services
- Pain/symptom management
- Respite for loved ones/caregivers
- Counselling/emotional support
- Physical, occupational and speech-language therapies
Making the call about hospice care as early as possible before a medical emergency or care crisis occurs is often the best approach. Many people leave contacting a hospice until the much later stages of a person’s illness unaware that they could have received significant support much earlier.
It might be time to consider hospice care for your loved one when they are experiencing the following problems:
- Problems with cooking, washing and other self-care tasks
- Decline in cognitive abilities
- Frequent falls
- Increasing confusion
Whether the patient requires hospice care for cancer, dementia, Alzheimer’s or something else, making sure that you have a hospice care plan in place can also help relieve some of the worry about the future both for the patient and caregivers.
Comfort care is a form of care usually provided for those nearing the end of their life. It focuses on providing relief from symptoms, optimize comfort and soothe the ill person. of the patient in the late stages of their life.
It is a term used commonly between clinicians and also between clinicians and patients families to mean end-of-life care and is used interchangeably between hospice and palliative care.
All of these terms refer to the care given to reduce pain and other illness symptoms while addressing the patient’s mental, emotional social and spiritual needs.
To qualify for hospice, a medical professional must decide that hospice care is suitable for a patient, by looking at expected course of the illness. Hospice is usually prescribed for patients whose life-expectancy is less than 6 months. After 6 months a physician must re-certify the patient to continue receiving care. There is no limit on the time that a person can receive hospice care.
What does a hospice provide at home? Hospice care in a home environment often involves things such as:
- Assistance from a hospice nurse,
- Assessment of home-help equipment needs,
- Visits from physicians and other medical professionals
- Family members receiving training to carry out tasks such as lifting or administering medication.
There is however, no exact home hospice care plan as each person is different and may have greatly differing needs. Some may simply require the occasional visit while other patients might require round-the-clock care.
Most hospices offer some form of grief counseling to patients and their families. This is usually delivered by a counselor trained in providing psychological and emotional support for people in this specific situation. Counseling can also take on different the forms such as:
- Individual counseling
- Family counseling (including children and teens)
- Grief support groups
The American Hospice movement started in 1974, with the launch of the Connecticut Hospice in New Haven. The movement took its inspiration from Dame Cicely Saunders, a British MD who opened Saint Christopher’s Hospice, in 1967 in Sydenham, England.
Now, nearly 42 % of terminally ill Americans are given some sort of hospice care and in 2016, approximately 1.43 million patients received hospice care in the USA.
Patients must be given less than six months to live in order to qualify for hospice care under Medicare qualifications. However, this does not mean that they will not qualify for hospice care after the six months has ended. The length of stay for patients varies greatly, depending on the point at which they are referred and it is not uncommon to be discharged from hospice care.
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Hospice care: Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home — in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient’s emotional, social, and spiritual needs as well as medical symptoms as part of treating the whole person.
Medical Definition of Hospice care, source: medicinenet.com, see full definition
Over 5 million Americans are currently dealing with Alzheimer’s and related dementias.
While in the beginning stages of Alzheimer’s disease, patients will experience memory issues such as losing things, they are still for the most part able to look after themselves with little support. However, once the disease has reached its late stages and physical issues have set in, finding a hospice for Alzheimer’s care becomes important.
Alzheimer’s disease and dementia progression can be slow. In order to ensure you get the best treatment for your loved one:
- Start the conversation about hospice care early so you can get all questions answered and create a plan in case of a crisis.
- Lean on your current medical care providers to help make an informed decision about when the patient is ready for Alzheimer’s-based hospice care.
The Alzheimers Association has specific information and guidance for those considering hospice for alzheimers.
Hospice care of one of the world’s leading performers became headline news in August 2018, when the “Respect” singer, entered hospice care at her home in Detroit. In the final stages of an 8-year battle with pancreatic cancer. Aretha’s move to hospice care signified that the iconic singer’s life was coming to a close and helped prepare and ease fans into this understanding. Reassurances were made that she was surrounded by the support of family and friends and comfort and care were being provided.
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- National Hospice Foundation
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- Hospice Foundation of America
- National Hospice and Palliative Care Organization
- American Hospice Foundation