Written By: Case Manager Suzanne Brown
November is National Hospice month. This began my thinking about hospice services and how I have experienced the benefits of hospice care with my clients and recently with a family member.
The term “hospice” was first used in medieval times referring to a place of rest and shelter for sick and weary travelers. Specialized care for the dying began in the United States in 1963 and the Medicare hospice benefit was enacted in 1982 by Congress to provide Medicare recipients with qualify end of life care. Today “hospice” refers to caring for patients who no longer benefit from curative treatments and have a limited life expectancy. It is designed to provide dignity and freedom from pain at the end of life. It does not prolong life or hasten death.
Currently over 1.64 million Americans and their families receive hospice services each year. A team consisting of a Registered Nurse, Social Worker, Home Health Aides, Chaplain and Volunteers work together with the physician to provide pain and symptom management, emotional and spiritual support, medications, medical supplies, instruction to family caregivers, and bereavement counseling. A Care plan is developed based upon each individuals needs. Hospice is beneficial to those suffering from cancer, end state dementia, Alzheimer’s disease, Parkinson disease, heart failure, renal failure, stroke and other conditions.
Hospice care begins with a referral from the physician to a hospice program. A representative from the hospice does an evaluation, and services may begin immediately or within a couple of days, dependent upon the needs of the recipient. For Medicare recipients, care is paid through Medicare Part A. Other payments sources include Medical Assistance, insurance, private pay, and charitable contributions.
Although 80% of hospice services are provided in the home setting, care is also provided in skilled nursing homes, personal care homes, and inpatient hospice facilities. Short term in patient care is available when the family caregiver needs respite, or when symptoms or pain cannot be managed at home. There is often a misconception that hospice services are limited to six months. However, a patient may receive these services as long as needed when the physician certifies that the recipient continues to meet the requirements.
My experience with a hospice program showed me how important it is to have the additional support during a very difficult time. The nurse visited daily and answered the questions that we had and explained to us what to anticipate and how to deal with the progressive dying process. The agency provided a hospital bed, medications, and medical equipment to ensure comfort. The Home Health Aides also visited daily and provided for physical needs as well as providing instruction to the family caregivers. With hospice supports it is comforting knowing that my loved one passed on peacefully, in her home and surrounded by family. She got her wish.