By Dr. Gerard Muraida
November is National Hospice and Palliative Care Month, when hospice agencies nationwide raise awareness about the highest quality of care for people coping with life-limiting illnesses.
Hospice prioritizes comfort and quality of life by reducing pain and suffering, as opposed to therapies focused on life-prolonging measures that may be painful and cause more symptoms. With an emphasis on care over cure, hospice also tends to a patient’s emotional and spiritual needs.
In fact, the term hospice originated in medieval times among the religious, when travel-weary crusaders on their way to the Holy Land would find refuge in monasteries. The word “hospice” is derivative of the Latin “hospes,” meaning host or guest. Eventually these places of rest came to be called hospices. Because great numbers of the pilgrims were in ill health, many probably spent their last days there.
The founder of modern hospice care is Dame Cicely Saunders, who was trained as a nurse, a social worker, and a physician. She epitomized the concept of “total care.” Dame Saunders founded St. Christopher’s hospice in London, focusing on a holistic approach to caring for the terminally ill. The first hospice in the United States, Connecticut Hospice, was established in 1974 by nurse Florence Wald, commonly known as the mother of the American hospice movement.
Today, there are well over 3,500 hospices across the United States. Close to 1.4 million individuals receive hospice care annually. Nevertheless, many people die without the benefit of specialized end-of-life care due to misconceptions regarding hospice.
Hospice is a philosophy of care, a Medicare benefit, and in some instances a location for the care of those with a life expectancy of six months or less. When a cure is not possible, hospice provides pain management, symptom control, psychosocial support, and spiritual care to the terminally ill. Palliative care brings this holistic model of care to people earlier in the course of a serious illness, when the life-expectancy is greater than six months. Specialized hospice training exists for doctors, nurses, chaplains, social workers and aides.
The Medicare benefit for hospice was established in the mid-1980s. It covers the cost of the hospice team, medications related to the terminal diagnosis, and any medical equipment deemed necessary. Most private insurance plans also offer a hospice benefit.
When symptoms can’t be controlled at home, the option for in-patient care is available where intensive symptom management can be administered. This is often done in a hospital, a nursing facility, or a free -standing hospice unit.
If you are wondering when is the best time to learn more about hospice, that time is now. Although end-of-life care may be difficult to discuss, it is best for patients and their family members to fully understand their care options well before they actually need them. Having a discussion early on allows the patient the opportunity to share their wishes, priorities, and goals, and patients can make an educated decision that includes the advice and input of family members and loved ones. When you learn more about hospice care early, it can greatly reduce stress when the time for hospice is needed.
Hospice care is a journey through which the health care team accompanies the patient and his or her family. Hospice does nothing to speed up or slow down the process of dying but allows for better quality of life and minimal suffering until the very end. For more information, contact a hospice provider near you.
