What is hospice?

Published by Chapster on 2005/4/16 (5611 reads)
Recently, ElderHope, as it does almost every month, recorded a Community Focus segment at KEOM FM 88.5. The topic dealt with hospice care.

What is hospice care?

Recorded March 30, 2005 with Dr. James Griffin, station director for KEOM 88.5 FM in Meesquite, Texas

Q: So, Mike, what are we talking about today?

A: Recently, addressing the case of Terri Schaivo in Florida, a radio commentator said that she was being confined in the hospital. It was, in fact, a hospice, not a hospital. It occurred to me that many of his listeners might be unfamiliar with hospice care. Certainly, there's a lot of confusion about it. But, really, it's quite simple. Hospice care refers to care that is given when a physician has determined that aggressive treatment will no longer help a patient, and the only other available option is what we call comfort care. It is care designed to make sure that the patient does not suffer, and is kept as comfortable as possible. It tries to ease the symptoms of the dying process.

Q: Do hospices in any way try to hasten death?

A: No. They do all that they can to ease symptoms such as pain, nausea, delirium, but they never intentionally seek to hasten the process of death. Indeed, most hospice workers that I know would be very uncomfortable with the idea. The point of hospice care is to ease symptoms so patients can live out whatever time they have symptom-free, and be able to enjoy their lives as much as possible, and accomplish whatever tasks they feel are undone in their lives. It is contradictory to the values of hospice to function in any other way. Having said that, hospice care also does not try to delay the dying process. Truly, hospice sees death as part of the continuum of life, as much as birth. The dying process has the potential for much growth and emotional healing as we pass through it.

Q: Specifically, what qualifies a person for hospice care?

A: As I mentioned earlier, the patient's doctor has to certify that he believes the patient has less than six months to live. Of course, that doesn't mean the doctor is right. It just means that based upon his or her clinical experience and certain set criteria, he believes that the person will die in that time span. What's amazing is that a meaningful percentage of patients seem to thrive under hospice care. They get longstanding pain under control, and other symptoms are powerfully managed, often as they have never been successfully before. With the support of the team members such as the social worker and chaplain, issues that worried the patient and family get attention and family is able to feel like there's at least a “plan” for what they're going through, and that they will be able to negotiate these difficult waters.

Q: What things adversely affect hospice care?

A: That's a really good question. The average length of stay for a patient on hospice is less than three weeks. And, really, the care team cannot effectively begin the process of helping the family in that time. It's very frustrating, because it takes time for the patient and family to feel an alliance with the team of caregivers that they receive. It takes time to get the medications balanced “just so” to give the patient the best combination of comfort and alertness. These things need more than three weeks, realistically. So, the biggest barrier to initiating excellent end-of-life care, hospice care, is that fact that, for whatever reason, patients, families, and doctors delay getting the loved one on hospice. And, really, its so simple. Just ask you doctor if your loved one is appropriate for hospice. If the answer is yes, ask your doctor for a referral to a hospice. Or ask for several hospices to evaluate. Search for the one that seems to fit you and the patient best.

Tags: end-of-life   terminal   hospice   palliative  

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