In some instances, medical treatment decisions are relatively easy: We get sick, our doctors prescribe a treatment, and we get better. But people who have run out of options to cure their illness often face difficult decisions regarding their treatment choices and end-of-life care. Their choices have a big impact on quality of life during their final days.
Each year, more than 1.5 million Americans who are nearing end of life decide to receive hospice care, according to the National Hospice and Palliative Care Organization (NHPCO), but many others who might benefit don't seek these services, perhaps due to misconceptions, fears, or a lack of information.
What Hospice Is — and What It's Not
There may be some confusion about what one can expect from hospice. A common misconception is that it is a "last resort" and means that a person is giving up hope, while some think it means a lower level of medical care or a way of denying treatment for a life-limiting illness.
In reality, though, hospice is not about giving up. If a person is no longer responding to curative treatment, hospice supports the highest possible quality of life for whatever time remains. It focuses on managing a patient's pain and other symptoms so they can spend their last days living comfortably in a setting they choose, surrounded by family and friends. It also helps family members manage the physical and emotional hardship of caring for a dying loved one.
Who Uses Hospice?
Hospice care is for people with a terminal illness who are expected to live six months or less. It is often associated with cancer patients, but others who receive hospice care may have heart disease, dementia, or lung disease. Typically, patients are concerned with the quality of their end-of-life period and can benefit from the specialized emotional and spiritual support of staff members.
What Happens in Hospice Care?
Hospice care starts as soon as a referral is made by the patient's doctor. Once admitted, the patient, family members, and a dedicated hospice care team will develop a plan that meets the patient's specific needs and wishes. The care team can include a primary care doctor, hospice doctor, nurse, spiritual care professional, home health aide, social worker, and pharmacist. Speech, physical, and occupational therapists are available if needed.
Hospice services can be provided at home but are also available at hospitals, nursing homes, assisted-living facilities, and dedicated hospice facilities. Staff members visit patients regularly and provide additional care or other services as needed 24/7.
Hospice is covered by Medicare, Medicaid, private insurance, and HMOs. If you're considering hospice for yourself or a loved one, check with your insurer for information about what services their plan covers. Many hospices will also help those who are unable to pay.
To learn more about hospice programs in your area, talk to a local doctor, nurse, or social worker, or contact your local or state office concerning aging. The NHPCO has an online provider directory at nhpco.org.
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