Introduction

This article was prepared with the help of material provided by the leading provider of hospice services in the United States, VistaCare. Through interdisciplinary teams of physicians, nurses, home healthcare aides, social workers, spiritual and other counselors, and volunteers, they provide care to thousands of patients each day.

What Is Hospice?

The term "hospice" was used in medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients in 1967 by Dr Cicely Saunders, who founded the first modern hospice - St. Christopher's Hospice - in London, UK.

In the USA today, hospice is a compassionate, patient-centered approach to medical care and support for people at the end of life and their families. It's focused on maintaining dignity, increasing the quality of life, and providing comfort, including pain and symptom control. Hospice care is fully covered by Medicare, by Medicaid in 41 states, and by most commercial insurers.

Hospice is primarily a concept of care, rather than a specific place. Services are provided wherever you call home: your family residence, a nursing home, an assisted living facility, an inpatient unit, or a hospital.

Is Hospice the Answer for You or Your Loved One?

After a diagnosis of a life-limiting illness, patients and their families should consider their choices for care. A patient does not have to be bed-bound or critically ill to be admitted to hospice. To help you decide if hospice is for you, there's an excellent online quiz at the VistaCare website. Click yes or no to a series of 10 very pertinent questions and you'll get a helpful answer.

Delaying hospice referral occurs for a number of reasons - family members have the attitude that they are going to fight to the end, which may, in effect, be counterproductive, and the patient may suffer more. They may see hospice as 'giving up', but in fact it can be easier for the patient approaching the end of life to reach emotional and spiritual peace, according to Dr Kevin Henning, a Regional Director for VistaCare.

Some US Hospice Numbers

• 81% of hospice patients are over 65, and 63% are over 75
• 80% of people with a life-limiting illness would prefer to remain in their own home
• 75% of consumers don't know that hospice care can be provided in their own home
• The average length of stay for hospice patients is 59 days
• 35% of patients die within 7 days of admission

These numbers suggest that there is general unawareness of hospice, and admission is often left until quite late in the patient's life. The different levels of care provided by hospice allow as much (or as little) substitution for the care being provided by the family caregiver as the participants wish.

What Are the Eligibility Requirements?

The simple answer: the hospice benefit is available to anyone with a life expectancy of six months or less if the terminal illness or disease runs its normal course. The patient, of course, must choose to elect hospice, and the patient's eligibility must be certified by a physician - most often the patient's personal physician in conjunction with the hospice's medical director. ('Expectancy' is based on a physician's best estimate, and is, therefore, only a rough guide.)

This short article is obviously unable to do more than scratch the surface of what you'll want to know about hospice care. Visit the VistaCare website or one of many organizations you can locate at the Hospice Net website, along with additional information on the hospice approach.