What is Hospice and Hospice Care?

Despite medicine’s best efforts, receiving hospice care means facing death.

The taboo and discomfort surrounding death make it difficult for people to speak up about the need for hospice care – and sometimes that can include clinicians. The taboo cuts across many industries, even affecting those who have worked in hospitals for decades.

However, there is another way to think about the end of life. This is where hospice comes in. But what is hospice? At its core, the hospice journey is a foundation of support, care, and compassion. It’s also a way to embrace the circle of life. It allows the patient and their family the time, space, and opportunity to be together with dignity and respect for the end-of-life process. How do patients and their families get to where they can focus on the best parts of living well while managing the transition to death?

Hospice is one big part of it.

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What is Hospice Care?

Hospice care is a series of non-curative treatments focused on alleviating pain and discomfort for people at the end of life, regardless of their age. More specifically, a team of medical staffers一varying from physicians, nurses, and social workers to chaplains and grief counselors一work together to provide hospice care to a patient and their family. This team aims to support the patient emotionally, physically, and spiritually as they traverse the transition from life to death.

Hospice is usually provided in a person’s home, in an assisted living facility, or in a continuing care retirement community. And in other cases, hospice can be provided in a hospital or a free-standing hospice community.

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What Does it Mean When Someone is in Hospice Care?

When someone is in hospice care, it means that the person and their family have decided to forgo curative treatments (e.g. chemotherapy) and focus on comfort measures instead. This can include things like pain management, symptom control, spiritual support, and emotional counseling for both them and their family members.

Of course, receiving hospice care doesn't mean the person has given up or stopped fighting. Quite the opposite – it means that they are fighting for quality of life, and focusing on making their last moments meaningful. It is about living well for as long as possible in a comfortable setting, surrounded by those who love them.

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What Are the Requirements to Qualify for Hospice?

Your primary physician can help you transition from palliative care, stop curative treatment, and ultimately begin hospice. But before starting hospice care, patients must meet certain medical criteria. The eligibility requirements for hospice care vary by state and insurance provider, but generally speaking, you must meet certain criteria. When you are ready to talk to your doctor, here are some requirements to keep in mind:

• A patient needs to have a terminal illness that cannot be cured or that they are uninterested in treating, resulting in death.
• A physician and a second physician must certify that the patient’s life expectancy is six months or less if the illness or condition were to run its normal course.
• A physician and a second physician must certify that the patient’s life expectancy is six months or less if the illness or condition were to run its normal course.‍
• Medicare, Medicaid, and many other private insurance providers can pay the total cost of hospice.

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Is Hospice Care Only for End of Life?

No, hospice care is not just reserved for the last days of life. While hospice care is often thought of as the last stop along a person's journey, it’s not just for those at the end-of-life stage. Hospice care can be provided to any patient who meets the criteria and has a six-month prognosis or less. This means that hospice care may start much earlier in the illness – when patients and families can benefit most from the services hospice offers.

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What Kind of Care does Hospice Provide?

Every person who chooses hospice will undoubtedly have their own emotional needs, physical pain thresholds, belief system, cultural background, and family support. When done right, hospice meets the patient where they are and unconditionally supports the patient and their family’s journey. What is hospice care and what are its purposes? For those unfamiliar with the ins and outs of hospice, here are some of the offerings available:

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Comfort care

A broad term that starts with pain relief but extends to massage, music therapy, spiritual support, and grief counseling. The patient and family decide what comfort means to them.

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Hospice nurse

At the heart of hospice care is a hospice nurse. The nurse assesses the patient, adjusts medications to provide pain relief, and coordinates other care services. Hospice nurses are compassionate, teaching professionals who can guide everyone through the dying process by calming fears and anxieties. Their goal is to improve the quality of patient care.

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Aides

Aides provide intimate support to the patient by gently assisting them with bathing, hygiene, continence care, and grooming. Aides will shave, cut nails, do bed baths, change underwear, cut hair, provide oral care, assist with catheters, and help with dressing and undressing.

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Hospice chaplain

A chaplain is dedicated to providing the patient with care and spiritual counsel. Some patients may have spiritual leaders or clergy that they prefer to use. Chaplaincy is entirely voluntary, and the purpose is to offer service that is consistent with the patient’s wishes.

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Respite care

This can offer family caregivers a break from having to assist their loved ones. Hospice offers respite care by placing the patient briefly in a hospice facility, hospital, or nursing home.

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Medical equipment and medical supplies

These are necessary when someone is ill and declining, especially if they are receiving care at home. For example, they may need things such as a hospital bed, wheelchair, walker, oxygen, crutches, blood pressure monitors, or CPAP machines, needles, catheters, and other valuable supplies and equipment.

How Long Do Hospice Patients Live?

The length of time a patient receives hospice care depends on their individual situation. There is no set timeline for how long hospice care should last, as each person’s experience is unique and often unpredictable. The average length of stay in hospice is typically between 70-90 days, but it could be less or more depending on the patient’s individual circumstances.

A hospice patient is eligible to stay in hospice as long as they meet certain criteria that are specific to their illness or condition.  If a patient’s condition improves, they may be discharged from hospice care. However, if the patient or family wishes to stay in hospice care and the patient meets all eligibility requirements, then they can remain in hospice for as long as necessary.

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When Should You Start Hospice?

The short answer? As soon as possible. It is not an easy decision, but one that is always reversible. In fact, despite the six-month “time limit,” some people can get recertified for hospice and live even longer. Others may even improve while in hospice care, and can eventually leave hospice.

For those facing the prospect of hospice, it is crucial to note that hospice care is not about giving up on life. At its most basic, hospice care provides patients the opportunity to live to the best of their ability while transitioning to the end of life. If you, as a caretaker, and your loved one are considering hospice care, don’t wait for the doctor to bring it up. In many cases, families report that they wish they had started hospice sooner.

Patients receiving hospice often report feeling better, having a sense of control over their well-being, and being able to focus on what is important to them. As you and your family discuss whether it is time for hospice, consider some of these factors:

• A rapid decline in health despite treatment. The conditions that bring people to hospice vary. They can be anything from cancer, heart failure, and kidney disease to dementia and ALS. At some point, aggressive treatment may fail to improve the patient’s condition and can become harmful and uncomfortable.
• A decline in functioning. Even with curative treatment, a patient can report increasing difficulty with activities of daily living such as walking, bathing, eating, using the bathroom, and getting dressed. An aide can help with these particulars as part of hospice.
• Reduced need to eat. Many people also experience a decrease in appetite, subsequent weight loss, and/or dehydration.
• A desire to eliminate doctor and ER visits. Patients and caregivers alike often tire of doctors and ER visits that don’t improve their condition. Unsurprisingly, a patient can eventually ask to discontinue treatment and medical appointments.‍
• Withdrawal and increased mental confusion. Sometimes withdrawal and mental confusion happen gradually, but other times without warning. Withdrawal and mental confusion often occur closer to the end of life.
• Uncontrolled pain. Controlling pain is a hospice specialty. Managing pain humanely and effectively is a quality-of-life issue.

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The Benefits of Hospice Care

Hospice care should not be seen as a failure of medicine or an admission that nothing else can be done. It is a humane way to provide compassionate and dignified end-of-life care. The support from hospice can enable families to make the most of their time left with a loved one, as well as prepare for life after they are gone—both emotionally and logistically. It can provide comfort, care, and companionship in the last months, weeks, or days of a person’s life.

Not only does hospice care provide physical comfort and emotional support, it also helps people to make sense of the dying process. Patients and their families can learn about what is normal during end-of-life transitions, making it far less frightening to manage. It is a place where pain can be managed and questions answered in a safe, comforting environment. A place where patients and families can feel supported.

Hospice care also helps people prepare for their passing in many ways, such as creating a meaningful farewell ceremony or helping to define legacy wishes that can live on after death. In addition, hospice is often the first step to getting assistance with funeral planning and other financial considerations.

At its core, hospice is not just about physical care, but also about emotional support for the entire family. It is about embracing life and living every moment to its fullest. Though it can be difficult to come to terms with the reality of death, those who receive hospice care often have the comfort of knowing they are being treated with dignity and respect as they live out the last moments of their life.

In the end, the benefit of hospice care is simple. Hospice makes the patient’s comfort the number one concern. It helps families honor their loved one’s wishes by providing the highest level of compassionate comfort care possible, with dignity, compassion, and respect at the end of life.

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How to Find Quality Hospice Care

At Guaranteed Hospice, our mission is to ensure you receive the highest quality of hospice care so that you and your loved one can experience the most meaningful end-of-life journey. We provide personalized, compassionate support and assistance for every family, no matter their situation. With our team of knowledgeable professionals, you will have the peace of mind that comes with knowing that your loved one is receiving the best care possible. Contact us today to learn more about how we can help you and your family navigate end-of-life decisions with compassion and comfort.