Hospices Offer Comfort at Life's End

It's a subject no one wants to think about, but for each of us, our lives must come to an end.

As medical progress prolongs our lives, the end can linger, draining patients and loved ones alike. So, more and more people are turning to hospice care.

Hospice is not just for the elderly or cancer patients. Children receive hospice care, as do patients with neurologically progressive degenerative diseases like Lou Gehrig's disease, Parkinson's disease, and HIV.

This holistic approach to the end of life treats pain and disease symptoms to make the patient as comfortable and functional as possible. Counseling helps patients and families come to terms with the process.

Idea has spread

Three decades after hospices spread to the U.S. from Britain, more than 1.3 million Americans receive hospice care each year, according to the National Hospice and Palliative Care Organization (NHPCO).

Medicare, Medicaid, and most health plans cover hospice programs. A patient can enter hospice care when a doctor assesses that the patient has a terminal illness, and says that he or she has six months or less to live. The patient, family, and doctor decide when hospice service should begin.

Although a person enters hospice with less than six months to live, hospice services don't automatically end at six months. Some people in hospice care live much longer. Medicare, for instance, continues to provide hospice coverage after six months, as long as the patient's doctor recertifies that the patient is terminally ill.

Team approach

Typically, a hospice patient is treated by a team of people. The team includes not only the patient's family members, but also a doctor, a nurse, counselors, a social worker, pastoral care services, home health aides, and trained volunteers. The goal is to control pain and symptoms so that the patient is comfortable yet alert enough to make decisions. The team also helps the family through the grieving process.

Some hospices have a facility where people receive care in their final days. But most hospice programs bring doctors, nurses, and other staff to patients' homes. Surveys show most Americans prefer it that way.

A hospice can give family caregivers a break through respite care. A trained caregiver will step in to allow family members some time off. Under Medicare, a patient under respite care can be cared for at home, at a hospice center, or at a hospital.

Despite these benefits, many people still have the misperception that you come to hospice at the end of a person's life.

Instead of a person waiting until the very last moment to enter hospice, hospice staff urge families to discuss end-of-life issues well in advance, while an ill person can still state his or her wishes.

Hospice also offers a multitude of support services for the patient and family. The relationship that develops with the hospice staff allows the care receivers to work through anticipatory grieving as well as the logistics of end-of-life issues. Patients express gratitude knowing that their family will not be left behind with no one to help them. Final preparations are made in collaboration with the patient. The final days can then be spent on closure, knowing that everything has been done to help the patient through the transition of dying.

To learn more

To learn about hospice care in your area, check into these resources:

• Doctors, nurses, and other health care professionals

• Social workers, clergy, and other counselors

• Friends or neighbors who have experienced hospice care

• Internet search engines

• Your local yellow pages

• Local or state offices on aging or senior centers