Elderly patient in hospital bed

Understanding Hospice Care

More adults now die at home than in the hospital, according to a 2019 study in the New England Journal of Medicine. Improvements in end-of-life care and the expansion of Medicare coverage to include hospice services in the early 1980s have contributed to this shift.

November is National Home Care and Hospice Month, the perfect time to delve into understanding what hospice care is, the benefits to patients and families and how to access this valuable end-of-life care.

What is hospice care?

Typically, hospice care starts when a terminally-ill patient has a life expectancy of six months or less. At this point, care shifts from lifesaving to life-affirming and focuses on making the individual’s final days comfortable and peaceful. A specially-trained team of health care professionals is assembled to help with pain management and other medical needs, while also supporting family members who might be aiding in their loved one’s care. Although most hospice services are provided in-home, care can also be provided at nursing homes, residential facilities and hospitals depending on the needs required.

Misconceptions About Hospice

Four common myths about hospice include:

  • Hospice and palliative care are the same thing. Hospice services often include palliative care, but palliative care isn’t exclusive to those in end-of-life care. Hospice care is designed specifically for those nearing the end of life, while palliative care can be used to manage pain and other symptoms resulting from non-life-threatening illnesses.
  • Hospice care is too expensive. Hospice care is typically covered by Medicare and Medicaid plans, as well as many private health plans.
  • Hospice is only for the very elderly. While most people in need of hospice care are older, pediatric services are available for children and teens diagnosed with a terminal illness.
  • Starting hospice care means a person is giving up. The decision to enter hospice care is unique to each patient, but people generally make this choice when prolonged treatment becomes ineffective and could result in a poorer quality of life.

Benefits of End-of-Life Care

For many families, hospice care offers several benefits, including:

  • 24/7 support: A care team is on-call all hours of the day, providing assurance to families that support will be available when they need it.
  • Control: Individuals can spend their last days in the comfort of their own home, without the intrusion of hospital staff. It also allows them an opportunity to actively weigh-in on their care.
  • Family help: Care teams often provide respite services, so loved ones are able to take breaks, and may include social workers and chaplains who can offer emotional and grief counseling for the family. Staff can also help families navigate tasks such as planning burial or funeral services.

Individuals and families facing a terminal diagnosis should talk to a primary care physician to discuss if or when hospice care may be an appropriate option.

About the author: Dr. S. George Kipa, MD, is deputy chief medical officer at Blue Cross Blue Shield of Michigan. 

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Photo credit: Katarzyna Bialasiewicz  

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