Hospice is a set of services that we all may need someday – if not for ourselves, for our parents. While death is not an option for any of us, we do have choices about the services we use at the end of life. Hospice ... offers a variety of benefits, not only to those of us who are dying, but also to those we leave behind.

What is Hospice?

Hospice includes medical care with an emphasis on pain management and symptom relief. Hospice teams of professionals and volunteers also address the emotional, social, and spiritual needs of the patient and the whole family. Overseeing all patient care is the hospice medical director who may also serve as the attending physician. Alternatively, the patient's own physician may continue in this role, in coordination with the hospice team and its plan of care.

Medical Care

Pain management is of particular concern for a patient with a life-threatening illness. Hospice staff are the experts in state-of-the-art pain treatments, helping patients feel comfortable with pain management alternatives. If administering pain medication requires a new skill, family members can count on the hospice staff for training and guidance.

Most medical treatments needed to make a terminally ill patient physically comfortable can be provided at home. Recent technological advances allow for a wide variety of equipment to be installed in the home, thus reducing the need for hospitalization, except in the most complicated cases. In rare cases when symptoms cannot be controlled at home, inpatient facilities are available.

Emotional and Spiritual Support

The fear of death is often due to the fear of pain and abandonment. Hospice staff includes bereavement and spiritual counselors who help patients and families come to terms with dying. They assist patients in finishing important tasks, saying their final goodbyes, healing broken family relationships, distributing precious objects, and completing a spiritual journey.

Unfinished business can make dying harder and grieving more difficult for those left behind. Hospice staff recognizes that a person who comes to terms with dying has a less stressful death, and that the family benefits from a less complicated grieving process. A source of relief and comfort for many hospice patients is the knowledge that the family will receive ongoing bereavement support.

Practical Considerations

The day-to-day chores of life can become overwhelming for family caregivers. Hospice staff can teach them to care for the dying person at home – administer medications, operate equipment and coordinate services. Volunteers are integral members of the hospice staff, providing companionship and assistance in household chores.

Financial Concerns

Financial worries can be a major burden for a patient facing a terminal illness. Most hospice patients are Medicare participants with ready access to a hospice benefit that minimizes out-of-pocket expenses in the last months of life. The Medicare hospice benefit covers prescribed medications, visits by medical and nursing professionals, home health aides, short-term inpatient care and bereavement support for the family after the patient has died. The Medicare hospice benefit also eliminates the burden of paperwork, as families are not required to submit claims or pay bills. For patients without hospice insurance, financial accommodations are made based on ability to pay.

Hospice: The Challenge to American Health Care Consumers

Hospice is easily confused with less attractive alternatives, and, as a concept, it suffers from a powerful denial syndrome in our society. Hospice must be better understood if it is to reach all those who need it. When all Americans know what hospice is, they will not only make it an explicit part of their long-term plans, but their fear of death will be abated. Increased visibility of hospice, locally and nationally, will result in more people becoming pro-active advocates for themselves and their families.

How is the American Hospice Foundation addressing the challenge?

The American Hospice Foundation's mission is to spread the hospice message in local communities and across the country. This is the message of hope that a dignified death at home is an option for all Americans and that grief support is readily available for all adults and children. To fulfill its mission, the Foundation conducts public education campaigns and fosters research that benefits hospice consumers.

To educate the public about hospice, the American Hospice Foundation works with strategic messengers such as employee assistance professionals, teachers, school psychologists, and pastoral counselors. These professionals are in the position of teaching or counseling others about grief, death, and dying issues. Since it is still difficult to discuss death in our society, we often begin our efforts with messages related to grief. When hospice organizations provide this information, they become community resources, the recognized experts, and, ultimately, more to our society.

The American Hospice Foundation fosters consumer-oriented research designed to improve access and quality of care. Currently, the Foundation is developing a hospice consumer report card that is designed to guide families toward high quality hospices, and to inform consumers about the most important features of hospice care.

By Naomi Naierman, President & CEO, American Hospice Foundation and Johanna Turner, What is Hospice? was originally published on the American Hospice Foundation website.
© 2009. American Hospice Foundation. All Rights Reserved.

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