A hospice, originally lodging kept by a monastic order for travelers, has become a trusted form of medical and emotional care for the terminally ill. Hospice focuses on relieving symptoms and supporting patients with a life expectancy of fewer than six months to live.
Palliative care (pronounced PAH-LEE-UH-TIVE) extends the same support for physical and emotional pain, but is not limited to those with only months to live. The goal of hospice and palliative care is to improve the quality of life and to support the patient during treatment. The care extends to the families of the patients as well, offering physical, spiritual, emotional and social support for the patients and family members.
History of Hospice
The first hospice opened in America in Connecticut in 1974, and four years later, the U.S Department of Health, Education and Welfare recognized hospice as a viable concept of care for terminally ill people. Two individuals are credited with the work of finding and establishing humane understanding and treatment for those who are terminally ill. British physician Dame Cicely Saunders, who founded St. Christopher's Hospice in London, believed and taught: "We do not have to cure to heal."
Dr. Saunders introduced her ideas of specialized care for the dying, known as hospice, to Yale University in 1963. A lecture she presented at Yale, which included pictures showing the positive benefits seen in patients and families, began a movement that, according to the National Hospice and Palliative Care Organization, now has its own month of recognition: November is National Hospice Month.
When to Consider Hospice
Being diagnosed with a progressive, life-limiting illness or condition is a daunting prospect, forcing one to face mortality and walk a path of unknowns and challenges. If the patient agrees that the focus of medical care should be comfort and quality of life, then it is appropriate to seek hospice care.
End of life is a time that generates intense feelings of anxiety, isolation, grief and confusion not only for the patient, but for everyone who loves that person. Knowing that one will be treated as a unique individual by caring personnel who understand and are equipped to meet approaching medical and emotional issues most certainly offers comfort.
Hospice Care Options
There are four levels of hospice care as defined by Medicare when end-of-life care became a provision of coverage. All hospice and facilities offer care based on these levels:
Routine Home Care
As long as the patient's symptoms are under control, the hospice team supports the caregivers in providing end-of-life care in the home, whether that is a private residence, assisted living or nursing home. This is the most common form of hospice care in the United States.
In the event of a medical or psychosocial crisis, 24-hour care can be provided in the home for brief periods.
Inpatient Respite Care
Caregivers occasionally need to take short breaks to maintain their own health. In this instance, the patient can be transferred to a hospice facility for a short-term stay (up to five days) while the caregiver takes a break.
General Inpatient Care
When symptoms can't be controlled in a home setting, this level of care may be provided in many hospitals and some nursing homes.
Recognition and support by the government was made permanent by Congress in the form of The Medicare Hospice Benefit in 1986 and since that time the movement has spread through public education, with more than 4,700 hospices organizations across the country. The helping hand of hospice care has softened the path that we all face eventually.
Written by senior housing writer Marky Olson.