Hospice Brings Comfort to Patients and Families at Life’s End

At the end of someone's life, the primary focus shifts from interventions that seek to cure or prolong life to those that support comfort, maintain quality of life and provide emotional and spiritual support. 

English physician and devout Christian Cicely Saunders pioneered "hospice care," a novel approach to caring for the terminally ill. Her approach, which strongly emphasized a caring and comprehensive approach, sparked a global hospice movement that spread quickly.

Hospice care can offer comprehensive support that meets a person's physical, emotional and spiritual needs, in addition to providing family members with the guidance and support they need during this difficult time. 

Hospice care can also help families create meaningful memories and celebrate life respectfully and compassionately.

If you have not heard of hospice care, you will at some point. The support and comfort to patients and their families come at a time of great emotion. It might be a terminal illness, after a devasting accident, following a period of long-term care, or just old age; the need for hospice is the time just before the end of someone's life.

Whether it's for yourself or a loved one, understanding what hospice is and how it works can help make tough decisions easier to manage. Hospice offers many benefits through the services provided by experienced professional staff members in an atmosphere designed with compassion.

Need for Hospice Growing

The number of hospice patients is growing. In 2020, 1.72 million Medicare beneficiaries decided to receive hospice care. The number of Americans selecting hospice care has increased by 6.8% since 2019, which is the biggest current year-over-year growth in raw numbers and as a percentage.

According to the National Hospice and Palliative Care Organization, about 60% of people who receive hospice care need long-term health care services before entering the hospice program. Both long-term care and hospice often are connected which can make it harder on the family since it goes on for such a long time.

Familiar Comfort

Hospice care provides a unique opportunity for families to bring familiar comfort to their loved one's last moments. Those receiving hospice services are surrounded by familiar faces like family, friends, and caregivers. All of these individuals come together to ensure that the patient is as comfortable as possible and can stay at home as they near the end of their life. 

Caregivers also work with families to create an environment that lets the patient feel at ease and relaxed while receiving care. This allows patients to be surrounded by familiar things, like their favorite blanket or chair, which can help keep them calm and bring a sense of peace during a difficult time. With hospice care, families can ensure that their loved one is being cared for in a setting where they feel secure and cherished until their last breath.

Mayo Clinic chaplain and principal investigator Jacek Soroka, Ph.D., says the end of life is so important that health care professionals cannot miss it.

Because we will all die. We will all go through it, and we need to have the same quality of care at the end of life as we do with other aspects of care.

Personalized Plans

Hospice care is about more than simply in-home medical support - it's about creating a comprehensive plan that meets the unique needs of you and your family. Hospice providers work hand in hand with families to provide in-home hospice care customized to their exact needs, ranging from managing pain or administering medication to providing emotional and spiritual support as well. 

The goal of a hospice provider is to ensure that individuals who are terminally ill, as well as their families, experience the best possible quality of life during the end-of-life journey. 

Hospice providers focus on comfort and dignity. This care includes physical, emotional, and spiritual interventions through a multidisciplinary team approach to meet the unique needs of each individual.

A Sense of Dignity

It's an unfortunate but sadly inescapable part of life -- death. Receiving hospice care is a compassionate and dignified way to approach the past days of someone's life, allowing them to die with dignity surrounded by family and friends. A significant component of hospice is providing support not just for the difficulty of saying goodbye, but also helping those left behind to understand what happens during the process and how best they can support the passing individual. This much-needed service allows loved ones to say goodbye in peace and provides comfort at such a stressful time.

Respect for the Patient's Preferences

Hospice care strives to ensure that each patient is treated with dignity, respect, and compassion. This extends to respecting patients' wishes regarding their medical treatment since hospice supports patients' autonomy through the end-of-life journey. Patients can be assured that their thoughts, feelings, beliefs, and values are respected as priorities in determining their medical decisions. 

Hospice professionals aim to provide compassionate end-of-life care that honors an individual's personal choices and preferences so that they can make this transition in the best way possible for them. This understanding of human dignity helps create a trusting relationship between patients and caregivers alike, building a sense of comfort in knowing that someone is there to support the unique needs of each individual.

Insurance Coverage

Medicare provides coverage for hospice services if criteria are met and a doctor confirms that a person is terminally ill. Medicaid coverage of hospice care also varies depending on the state program. Generally, hospice cannot last for more than 60 days. Private health insurance policies may cover some or all of the costs associated with hospice care and should be discussed with the insurer. Most Long-Term Care Insurance policies will pay for hospice if the policyholder exhausts their Medicare hospice benefits. Most reliable hospice providers will know the rules. 

Numerous organizations offer free hospice services, including nonprofit hospices, veterans' organizations, religious organizations, and volunteer-based organizations. Some of the larger hospice organizations include the National Hospice and Palliative Care Organization, Catholic Charities USA, Hospice Foundation of America, and VITAS Health. There are limitations to many of these options. 

Hospice care requires a medical professional to evaluate a patient's needs and develop a tailored care plan. A doctor or nurse must assess the patient's comfort level and their physical, mental, and psychosocial needs. They may also provide other medical interventions, such as pain and symptom management or spiritual counseling. Additionally, a medical professional must regularly evaluate and adjust the plan of care to meet the patient's changing needs.

Counseling for the Family

Family counseling through hospice care is a powerful way to find comfort and guidance in difficult times. During the arrangement of hospice services, it is an option to include counseling and other supportive services, so families can cope with the emotional strain of their loved one's illness. 

Counselors provide a safe environment and focus on coping with grief healthily, making decisions about end-of-life care, understanding legal documents, and more. Hospice also ensures that families bond together during this delicate time as much as possible. 

A family counselor understands the complexity of relationships between family members and helps maintain peace within each household while they are going through such a difficult period. Family counseling through hospice care supports families from start to finish.

Religious Dimensions

There are religious dimensions of death and dying. Not everyone practices a religion or spirituality. However, some people only come to terms with this aspect of themselves when they are in danger of dying. Often hospice will include the religious and spiritual needs of the individual and their family.

Patients and their families often ask questions that are more spiritual and religious. Some of the things people often ask include:

• Why is this happening to me?
• What will happen when I die? 
• If there is a God, will He be there for me?
• What was the meaning and purpose of my life?
• Will I be remembered?

A hospice chaplain or other priest, minister, rabbi, or other religious leader is often involved. 

For example, for Roman Catholics, the Last Rights, or Viaticum, includes three sacraments - confession, the anointing of the sick, and the final Holy Communion. Each of these is a way to cleanse a person's soul of sins in preparation for the afterlife. 

Muslims practice special rituals for preparing the dying and the deceased. The Talqeen is performed for those near death to ensure they are spiritually ready for the journey into death.

Buddhists have prayers that may bring comfort and peace to someone dying.

People usually need a feeling of peace when they are near death. Being spiritually prepared is important for many people, whether it is a formal religious prayer or a conversation with loved ones.