Many hospice organizations incorporate a dove into their logos, because it's a symbol of peace. Hospice care in the United States has steadily gained acceptance as a peaceful end-of-life solution for millions of Americans. The demand for hospice care has increased substantially since it began in the 1970s and as Baby Boomers age, the number of people opting for this type of care is expected to continue to rise, according to the National Hospice and Palliative Care Organization (NHPCO).
Here are some important points from NHPCO's latest report about hospice care:
- In the United States, an estimated 1.6 to 1.7 million people enter hospice care annually. This is an option that can offer relief from pain and treatment for symptoms such as loss of appetite, difficulty sleeping and depression for people who are diagnosed with six months or less to live.
- Hospices focus on palliative care. The goal of this type of care is to make patients with serious illnesses comfortable — not to cure them.
- While it's hard to talk about end-of-life issues, hospice care is a solution that helps both patients and their families through this tough time emotionally and medically. Hospice personnel are trained helping families reach the decision for this care and carry it out with comfort.
- It's important to consult a lawyer before families reach a critical stage for their loved ones to make sure the patient's wishes will be carried out, that directives regarding medical care are clear (including do-not-resuscitate orders), and the patient's estate is in order.
- There are an estimated 6,100 hospice programs in the United States, with about 68% run by for-profit companies. Hospices range in size from small all-volunteer agencies caring for less than 50 patients a year to large corporate chains that take care of thousands of patients.
- Hospice care can be received at a patient's or family member's home, a residential facility including a nursing home, an inpatient hospice facility or elsewhere. It's common for patients and family members to opt for hospice care in their homes. Staff and doctors visit the home and deliver services as needed.
- Medicare is the predominant source of payment for hospice care in the U.S. and accounts for approximately 85% of reimbursements.
The Way it Works
The hospice team develops a care plan that meets each patient's need for pain management and the control of his or her symptoms. It may involve a large team including doctors, nurses, social workers, spiritual and bereavement counselors. After a patient's death, family members are entitled to bereavement counseling covered by Medicare or Medicaid.
Just over 41% of those who receive hospice care are age 85 and older. In terms of gender, 53.7% of patients are women and 46.3% are men. About 36% of them have cancer. The top four non-cancer diagnoses in hospice care include dementia, heart disease, lung disease and stroke or coma.
People often ask for hospice only in the last few days of life, but if done earlier, it can be provide comfort to family and more pain control for the patient. Besides the suffering of the dying patients, the day-to-day chores and emotions can become overwhelming for family caregivers. Hospice caregivers can be on call 24 hours a day, seven days a week.
End-of-life care and the related issues are sensitive topics, which is why it is best for family members to share their wishes long before it becomes a concern, according to the NHPCO. "Decisions about end-of-life care are deeply personal, and are based on your values and beliefs. Because it is impossible to foresee every type of circumstance or illness, it is essential to think in general about what is important to you. Conversations that focus on your wishes and beliefs will relieve loved ones and healthcare providers of the need to guess what you would want."
More Issues to Consider
- Doctors are often reluctant to initiate a conversation about hospice care because they don't want to leave the impression that they're giving up. Develop a working relationship with doctors if you can and have frank discussions about the options available.
- Hospice is considered a Medicare and Medicaid benefit for the last six months of a patient's life. Some private insurance plans also provide coverage. This coverage requires that family members have a medical consultation with the attending doctor who will certify the patient is terminally ill. For more information, visit the NHPCO website.
