What is Hospice Care

As much as it is a service, hospice care is a philosophy that incorporates a multidisciplinary team approach in providing supportive care to people in the final phase of a terminal illness. Hospice offers the services of trained volunteers who visit patients, run errands, provide transportation and help in other areas as needed.

Hospice care is designed to focus on comfort and quality of life, rather than on a cure. Although hospice care does not aim for cure of the terminal illness, it does treat potentially curable conditions such as pneumonia and bladder infections, with brief hospital stays if necessary. The hospice goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. This means that aggressive methods of pain control may be used if a patient so desires.

  • Services provided include the administering of drugs for pain control as well as for the management of other symptoms.
  • Social services that include dietary and other counseling as well as physical, occupational, and speech therapy are also available as part of the hospice service as is help in procuring medical supplies and equipment and providing continuous home care at times of crisis.
  • Hospice programs generally are home based, but they sometimes provide services away from home-in freestanding facilities, in nursing homes, or adult foster homes. 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.

How will I know if it's the right choice? Hospice care requires the referral of a physician; however, the choice of which hospice service to use is a personal decision. Hospice care is appropriate when there is a life expectancy of six months or less. When curative treatments are no longer working and/or a patient no longer desires to continue them, hospice becomes the care of choice. The mission of hospice is to affirm life and to view death as a natural process. Hospice is not designed to hasten death or "help" someone die, but rather to help patients live the remainder of their lives as fully as possible. Most people, if asked, will say they dream of a peaceful, comfortable death surrounded by their loved ones. An interdisciplinary team of trained professionals work together to deliver hospice services that can make that dream a reality.

It is important to note that a life expectancy is never "by the book." Some patients with a life expectancy of six months will live much longer and some will die much sooner than expected. It is generally accepted that the sooner a patient can access hospice services, the more they will benefit from the care they receive. A patient is ready for hospice when they have decided to pursue treatments meant only to promote comfort, not cure the illness. Those treatments may include medications to relieve pain, nausea, shortness of breath, loss of appetite, muscle cramps, itching, hiccups, and many more. They may also include more aggressive palliative treatments when the goal is to alleviate pain and discomfort, not cure the disease.

If I decide to receive hospice care can I stay home with my family? Yes, in fact hospice care is most often provided at home, however, someone who is in a skilled nursing home, adult foster home, or assisted living facility may also receive hospice care.

Are family members involved in hospice care? Yes, hospice views patients and family members as a care unit. Hospice encourages family members and friends to not only remain close by but to participate in the patient's care as much as possible. When family members cannot provide as much care as may be needed at certain times, hospice personnel will try to meet the patient's needs by exploring other options. It is important to understand that hospice insurers, including Medicare, don't pay for round-the-clock nursing. Family and friends are the primary caregivers with 24-hour access to hospice staff members who are on call to help manage a patient's symptoms and to support the family.

Pray That Your Journey be Long

When you set out on your journey to Ithaca pray that the road is long, full of adventure, full of knowledge.

The Lestrygonians and the Cyclops, the angry Poseidon--do not fear them: You will never find such as these on your path if your thoughts remain lofty, if a fine emotion touches your spirit and your body. The Lestrygonians and the Cyclops, the fierce Poseidon you will never encounter, if you do not carry them within your soul, if your soul does not set them up before you.

Pray that the road is long. That the summer mornings are many, when, with such pleasure, with such joy you will enter ports seen for the first time; stop at Phoenician markets, and purchase fine merchandise, mother-of-pearl and coral, amber and ebony, and sensual perfumes of all kinds, as many as sensual perfumes as you can; visit many Egyptian cities, to learn and learn from scholars.

Always keep Ithaca in your mind. To arrive there is your ultimate goal. But do not hurry the voyage at all. It is better to let it last for many years; and to anchor at the island when you are old, rich with all you have gained on the way; not expecting that Ithaca will offer you riches.

Ithaca has given you the beautiful voyage Without her you would have never set out on the road. She has nothing more to give you.

And if you find her poor, Ithaca has not deceived you. Wise as you have become, with so much experience, you must already have understood what Ithaca means.

Constantine P. Cavafy (1911)