Hospice
What is hospice? Why would I choose it?
If you or your loved one receives a terminal diagnosis of six months or less, hospice is an option. Unlike a hospital, hospice does not seek to cure. Rather than fight to prolong life through aggressive treatment and clinical trials, the primary focus becomes you or your loved one’s emotional well-being and physical comfort. Hospice generally provides pain management care, spiritual and psychological aid, a private space, and unlimited family visiting time.
What kind of hospice care is right for me?
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There are four different levels of hospice care depending on your care needs and health status: routine care, continuous home care, general inpatient care, and respite care. Each level of care differs in involvement in care from hospice staff. Routine and continuous care both occur in the home, while general inpatient care and respite care occur in a hospice care facility.
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Routine care is employed when you or your loved one is generally stable and the signs and symptoms of death are manageable with weekly at-home visits from hospice providers.
As your symptoms progress, continuous home care may be brought in to more actively regulate your or your loved ones' symptoms. Hospice staff is on-call to provide prescriptions and to make occasional visits for specialized nursing tasks and provide prescriptions. Most day-to-day care rests with family or hired health aides. While dying at home may seem ideal, it is important to consider the needs of all involved, including you, your loved one who is receiving hospice care, and all caregiver(s).
As your or your loved one’s health deteriorates, family/caregiver(s) provide for all the daily tasks: bathing, feeding, toileting, changing bed linens, administration of medication, and providing comfort in the case of patient agitation and delirium. In a situation such as increased pain levels, you or your loved one’s caretaker must contact the hospice and wait for a medical professional to provide the prescription and medication. While dying at home initially sounds ideal, you or your loved one must look at both the benefits and the possible difficulties. In the case of a sole caretaker, particularly a spouse, the impact on their mental and emotional health must be considered.
Respite care can be utilized to provide relief and rest to the caregiver(s). Respite care allows families to place their loved ones in inpatient for up to 5 days, allowing the caregiver to focus on their own needs.
General inpatient care may be a good option if you or your loved one need the more attentive level of care provided in a facility. In general inpatient care, you or your loved one have quicker access to medicine and are provided with constant care from hospice staff. For many individuals, inpatient care is saved for the final week(s) of their or their loved ones life. Inpatient care provides as needed pain-managing medicines for relief of symptoms associated with dying.
How do I apply for hospice?
You or your loved one should ask your doctor, social worker, or other medical professional about hospice availability if the prognosis of terminal illness is made. If you or your loved one believes you need hospice care, contact one of your healthcare professionals—they will certify eligibility for hospice and arrange for enrollment.
Can I be discharged from hospice?
Yes. The following instances could lead to discharge from hospice: 1) your health may improve, and you no longer fit hospice requirements for care; 2) you choose to revoke your hospice care to pursue curative efforts; 3) you move outside of the hospice’s service area; 4) you decide to transfer to another hospice; or 5) your behavior or that of one of your loved one’s is deemed to be disruptive, abusive, or a barrier to care.
How do I know if the hospice will provide good care?
At its advent, hospice was created to recognize the sacred (though not necessarily religious) nature of dying and provide a space to die with dignity. While many hospice care facilities continue this tradition, the rise of for-profit hospice care facilities make it harder to know if you or your loved one will get the care and dignified death you deserve. When choosing a hospice care facility, it is important to ask questions and do your own research. Make sure to talk to your friends, read reviews, and ask the hospice facility specific questions pertaining to you or your loved one’s care and end-of-life plan.
Other great hospice resources:
Medicare offers a very useful tool for comparing facilities:
Other great resources: