There is a lot of confusion out there regarding palliative care and hospice care. We’ve already looked at palliative care in detail in Palliative and Hospice End of Life Care, so now we’re going to look at hospice care.
Focus on Caring and Comfort
Hospice care focuses on caring and comfort instead of actual treatment for whatever condition the patient is dealing with and is usually implemented in the last six months of a patient’s life. Care can be provided in a patient’s home, in “hospice centers, hospitals, nursing homes and other long-term care facilities” (National Hospice and Palliative Care Organization) and to any patient regardless of age, religion, race or illness. Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations cover hospice care.
There are close to 5000 hospices in the U.S. and approximately two out of three hospice patients are over the age of 65.
A Team Effort
With hospice care, it is usually a family member who is the primary caregiver and who helps make health care decisions on the behalf of the terminally ill patient. A hospice team develops a care plan depending on each individual patient’s pain management and symptom control needs. As part of that team, hospice workers are on call 24 hours a day, seven days a week and make regular visits according to each patient’s care plan to assess the patient’s comfort and to provide additional care or services when needed.
Other hospice team members can and usually consist of:
• Patient’s primary physician
• Hospice physician/medical director
• Home health aides
• Social workers
• Trained volunteers
• Speech, physical and occupational therapists
Main Hospice Services
With its interdisciplinary skill set, the hospice team can provide the following services, (though this list is by no means exhaustive):
• Pain and symptom management
• Counsel regarding the emotional, psychosocial and spiritual aspects of dying
• Delivery of medication, medical supplies (eg: catheters, bandages) and equipment (eg: beds and wheelchairs)
• Administration of medications for pain relief and symptom management
• Instructions and advice on how family members are to care for the patient
• Personal care (eg: dressing, bathing)
• Speech or physical therapy if needed
• Short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time
• Bereavement care and counseling to surviving family and friends
Hospice care can be provided in a patient’s home so long as symptoms are controllable, in which case the patient’s needs would dictate the number of visits required by various hospice team members. Continuous nursing care is an option if the patient’s symptoms become too difficult for family members to control and the patient still wishes to be treated at home.
More information about hospice care can be found by following the links at the end of this article.
Hospice Foundation of America
National Hospice and Palliative Care Organization http://www.nhpco.org/i4a/pages/index.cfm?pageid=4642
Home & Hospice Care of Rhode Island http://www.hhcri.org/tabid/185/default.aspx
Reviewed on August 25, 2011
by Maryann Gromisch
Edited by Jody Smith