Hospice care is an underutilized resource for patients with cancer and other terminal illnesses. The medical literature offers many reasons for this, such as poor communication and misconceptions. But I think we all know the main problem: no one wants to think about dying.
I took the volunteer training class for Hospice Austin, and I would like to share their philosophy: “Live until you die.” Hospice care is available for the estimated last six months of life, and the goal is to get the most out of this time. Medicare, Medicaid, and many private insurance companies pay for hospice care for qualified patients. Both non-profit and for-profit hospice organizations offer services.
According to a recent article in the Oncology medical journal, more than 50% of patients diagnosed with cancer in 2008 died in the same year. While survival rates for cancer are improving, the last six months of life will come for each of us some day. Hospice care provides services to maximize the quality of life during that period. Unfortunately, many patients who are qualified for this care receive little or none because of late referral. During my training class, I learned that the average patient at Hospice Austin lives for only 2 weeks after entering the program. One patient died while the nurse was performing the initial evaluation to get him admitted.
Hospice care happens primarily at home. Inpatient services are limited to crisis management and specialized symptom management. The hospice team consists of a nurse, a social worker, a chaplain, and one or more volunteers. The patient may have a primary caregiver in a private home, or live in a nursing home. When the patient lives with relatives, the hospice volunteers provide supervision so the family members can go out for shopping, errands, and personal time.
The hospice nurse is the key provider of home care. She (or sometimes he) visits the home to perform procedures and monitor the patient's welfare. The social worker helps with other services, including financial aid to indigent families. The chaplain provides religious counseling and support. Volunteers provide a variety of services. They may build wheelchair ramps, transport patients, read, converse, or just listen. Hospice patients may receive treatment very similar to what patients in curative care receive: chemotherapy, radiation, etc. The difference is that the goal of treatment is palliative rather than curative. For example, the patient may feel more comfortable with treatment to reduce the size of a tumor, even if the cancer has metastasized and is considered incurable.
Sometimes hospice patients go into remission and live far beyond the expected six months. If the condition stabilizes, the patient can be released from hospice care and still re-enter at a later time. So you have nothing to lose by checking out this important health care option.
Reference:
Prince-Paul M, “When hospice is the best option: an opportunity to redefine goals”, Oncology (Williston Park). 2009 Apr; 23 (4 Suppl Nurse Ed): 13-17.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.