If you are thinking about hospice, you know that the decision can be a
difficult one. It means that you or your loved one is nearing the end
of life. It is normal to feel many emotions when hospice is discussed.
You or your loved one's health care providers can help guide you in
making the decision. But keep in mind that the goal of hospice is to provide
comfort. This is done for both the person who is ill and his or her family.
Hospice is about ensuring quality of life during the time a person has
left. Symptoms are controlled. Emotional and practical matters are taken care of.
Beginning the Hospice Process
A doctor must confirm that you or your loved one qualifies for hospice.
A person with illness can go into hospice when a doctor believes he or
she has about 6 months or less to live. You can then choose a hospice
to make this time as comfortable as possible.
Choosing a Hospice
When you are looking at hospices, ask questions. What are their services?
Where do they provide care-at home or in a facility? Ask for a copy of
the hospice's Patient's Rights and Responsibilities. To learn
more about your local hospices, contact:
- health care providers or hospital staff
- Your place of worship
- The local agency on aging
- The local Visiting Nurse Association (VNA)
- Your local United Way
- The Veteran's Health Administration office
- State department of health or social services
- The state hospice organization
- The Hospice Foundation of America at www.hospicefoundation.org
- The National Hospice and Palliative Care Organization at www.nhpco.org
The Hospice Team
Hospice is provided by a team. The team usually has a doctor, nurse, and
social worker trained in hospice care. It may also have a home health
aide, spiritual advisor, volunteers, and others. The patient is an important
part of the team. He or she can voice his or her wishes and goals. If
hospice is done at home, family members give day-to-day care. A home health
aide can make visits. They can help with cooking, bathing, and bathroom
needs. A nurse, social worker, and other professionals will visit. And
a hospice nurse or doctor is on call 24 hours a day to answer questions
and handle problems.
Preparing for Care at Home
Hospice is often done in the home. Family members are the main caregivers,
with support from the hospice team. The team may help you arrange care.
They may also help set up the home. They can provide medical equipment
as needed. This may include a hospital bed, commode, oxygen, or other
supplies. The hospice can also help the family get breaks from caregiving.
This is called respite care. For a short period of time, the hospice patient
can be put into a facility. This lets caregivers take care of other needs.
If hospice is already being done in a facility, all of these things are
taken care of on-site.
Symptoms such as pain, nausea, anxiety, breathing distress, and sleep problems
are treated. The hospice program will provide medications to ease these
symptoms. The team will teach you how to use them. Treatments that are
no longer beneficial may be stopped. The team will discuss what treatment
changes may be needed. And caregiver training may be given to family members.
Both the patient and family can get counseling. This is to help with anxiety,
grief, family conflict, and spiritual issues. Bereavement support is given
for up to 13 months after the patient dies.
The hospice team helps the patient and family understand the illness and
how it progresses. They can help both the patient and family review options
so decisions can be made. The team can help with finding legal resources
and answering insurance questions. And they give information about how
to make funeral and memorial arrangements.
The patient's primary care doctor will have contact with the hospice
team on a regular basis. If the patient's health improves, he or she
may no longer meet the terms for hospice or need hospice care. In this
case, the patient can end the hospice care and start it again later as
needed. A patient can go back to hospice at any time by being re-certified
by a doctor. Also, a patient has the right to leave a hospice at any time
for any reason. A patient can also change to a different hospice if he
or she is not happy with the care.