So many times, at church or other places, I’ve heard someone say, “Hospice has been called in” when referring to a sick or elderly friend or family member. It sounds so ominous, like the final grains of sand are slipping through to the bottom of the hour glass. “Called in”…what does that even mean?
What are palliative care and hospice care?
On this blog, we frequently discuss the stress that can go along with caregiving. Indeed, it can be a daunting task to care for someone who is no longer able to live independently or is critically ill, and more and more Americans are taking on this caregiver role as their parents become elderly. Simultaneously, there is also an increasing focus in our country on providing patients with compassionate, dignified care, especially as they deal with a serious illness or reach the end of their life. This is where palliative care and hospice programs can assist.
Both care methodologies strive to provide comfort to the patient and their loved ones using a multi-pronged, collaborative team approach. The key difference is that palliative care can begin at the time an illness or condition is diagnosed and can be provided concurrently with curative or life-prolonging treatment of the condition. Hospice care, on the other hand, begins after treatment of the disease or condition ceases, when it becomes clear that the patient is approaching the end of their life.
For people who have been diagnosed with a serious illness, palliative care specialists are able to provide the advanced care necessary to ease symptoms, relieve pain, and help them and their loved ones cope with the emotional stress of the illness. Depending on the individual’s unique situation and wishes, palliative care patients may or may not be undergoing curative or life-prolonging care.
The foremost goal of palliative care experts is to provide comfort measures, as well as therapeutic treatment in some cases, potentially helping the patient recover and return to some level of health, though many palliative care patients will not fully recover. These special caregivers may include physicians, nurses, dieticians, medical social workers, and chaplains, and care services may be provided within a healthcare facility or in a private home.
According to the National Hospice and Palliative Care Organization, in 2014, over 1.6 million patients received hospice-related services. Hospice care offers special services to those who are dealing with the final stages of a terminal illness–meaning there will be no recovery–and their loved ones. Patients receiving hospice services usually have less than six months to live and typically have discontinued curative or life-prolonging measures. So, recovery is not the goal of hospice care; rather the focus is upon respecting the dignity of the patient and improving the quality of their last days, including the proper management of pain and/or other physical symptoms, and attending to the emotional and spiritual needs of the patient and their loved ones.
Hospice care services are provided by physicians, nurses, medical social workers, grief counselors, chaplains, and oftentimes volunteers. Patients may receive this end-of-life care in the home or in a healthcare facility; some hospitals even have special units dedicated exclusively to hospice care for short-term inpatient stays.
It should be noted that Medicare Part A covers palliative and hospice care, as do Medicaid (in some states) and many private insurers. Some care providers even offer their services regardless of the patient’s ability to pay.
There are several misconceptions when it comes to hospice care. First, people often assume that hospice is just for the elderly. The reality is that hospice care is available to anyone in the final stages of life, regardless of age. Another common myth is that hospice is only for people with cancer. Not so. While cancer patients and their families do make up a large portion of hospice care recipients, the service is appropriate for any terminal illness including, but not limited to, Alzheimer’s disease, heart disease, liver disease, Lou Gehrig’s disease (ALS), or stroke patients, as well as for people who are simply nearing the end of their life due to natural causes.
A changing mindset that warrants new nomenclature
I understand that the point of emphasis in saying “Hospice has been called in” is to make it clear that there will be no recovery for the patient–they are approaching the end of their life. But I wonder if there isn’t a better way of describing this? Why not create terminology that reflects what hospice care providers actually do (or should do, if they are good): help people have a good life, all the way to the end. Hospice care can make the last stages of life as meaningful as possible, free of suffering, helping the person maintain as much dignity as possible. After all, providing comfort, physically and emotionally, to the patient and their loved ones is the ultimate gift when it comes to compassionate end-of-life caregiving.