Do you know what hospice is? Many people have heard the term, but most don’t know exactly what it is. And there are misconceptions surrounding hospice care.
Pulling the plug. Quitting. Dying early. Doing nothing. Do these assessments of hospice sound familiar? We hear them frequently.
What is hospice? It is a form of care in which the primary goal is to provide comfort and maximize quality of life in the setting of an incurable and terminal diagnosis. Said another way, the goal of hospice is to treat the symptoms of a given disease, rather than attempt to alter the course of a disease. No attempt is made to lengthen one’s life, but again improving the quality of the remaining life they have.
To qualify for hospice, one must have a terminal condition that a medical provider in his or her educated medical opinion expects a patient to live no longer than six months. Common conditions include many cancers, severe heart or lung disease, or kidney failure. Many more diagnoses qualify for hospice as well.
Hospice care does not hasten death, it simply makes the symptoms of a terminal illness more tolerable, as the illness takes its natural course. In fact, in certain forms of lung cancer, some patients actually live as long as those patients receiving aggressive cancer therapy.
Hospice provides many forms of symptom management. For example, there are medications to treat pain, shortness of breath and anxiety, among other symptoms. Any medications not strictly geared toward comfort are generally discontinued. In addition, hospice care provides in-depth nursing services, medication management, bathing assistance, physical and occupational therapy, non-denominational religious counsel and non-spiritual counsel. Twenty-four hour care is not provided as it is logistically impossible. Therefore, much of the day-to-day care is provided by family and friends, under the direction of hospice staff. However, hospice patients and their family do have 24-hour access to a hospice nurse for any situation that requires urgent attention.
Hospice care is covered by Medicare and all commercial insurances. Practically speaking, when covered by insurance, care is only provided in one’s home with a few exceptions.
Occasionally, caregivers do need a break, so a patient may be transferred to a hospice facility for a short period of time to offer respite to their caregivers.
If a person lives longer than six months, their illness can be re-evaluated, and if the medical provider again determines that the illness is terminal, that person may be recertified for hospice care. If one’s illness has significantly improved, hospice may be revoked. And if a patient no longer wishes to be cared for under hospice for any reason, it may be revoked at any time.
Dr. Kris Schamber is a board certified internal medicine physician with Sheridan Memorial Hospital’s Big Horn Mountain Medicine.