It is comforting to read that someone you care about passed away at home surrounded by family and friends. But how does that happen?
Typically that person has chosen to receive something called hospice care. Most people don't like to think about the end of life, but considering these issues now, while you are healthy, can help you determine if you would like services such as hospice care should you develop a life-limiting illness.
Hospice care brings together medical care, pain management and emotional and spiritual support for terminal patients and their families. The goal is not to cure the individual but to promote quality of life with an emphasis on comfort and dignity in the patient's setting of choice: home, nursing home or assisted living environment.
A patient is eligible for hospice if the attending physician feels the patient is likely within the last six months of life. A referral for hospice services can be generated at the physician's initiative or if the patient or family raise the question and the physician agrees that hospice is appropriate.
Questions you should ask when choosing a hospice provider include: does the service have a full time board certified hospice and palliative care medical director? Are the hospice nurses board certified in hospice and palliative care? Is there a social worker who will help me/my family determine what other services we need and how to get them? What type of grief/bereavement support is available?
Your hospice team works under the direction of your primary physician and includes physicians, nurses, social workers, chaplains, volunteers and home health aides. The team helps with the physical, emotional and spiritual issues related to the patient's illness. In addition, a bereavement coordinator can help the family adjust to the loss of their loved one.
Care may include medications to manage pain or symptoms, assistance with personal care, and support to achieve personal goals when possible such as attending a wedding, taking a trip or putting together a scrap book. Volunteers can help provide relief for your family members or assist with errands. Care providers also can help family members understand what the patient is going through.
Why do some people choose hospice rather than continue with treatments? For some, it is a matter of how they want to spend their time. Hospice care frees patients from spending hours receiving infusions, days or weeks recovering from surgeries or extended periods in the hospital. They can be with loved ones doing things they enjoy often without the side effects that can come from some treatments.
The experience of many hospice patients is that they are taking control and spending their remaining time on their own terms with support to minimize pain and other symptoms. Their hospice providers become like an extended family and source of not only physical but also spiritual and emotional support as needed in preparation for the end of life.
Hospice also provides the medical supplies, medications and equipment needed for management of the patient's condition. Hospice nurses visit the patient regularly and are on call seven days a week, 24 hours a day. Most insurances, including Medicare and Medicaid, cover Hospice.
Getting to know what hospice is and how it can help at the end of life can prepare you and your loved ones for a future decision about hospice care.
Nesbitt is director of Susquehanna Health Hospice.