From OncoLog, June 2012, Vol. 57,
House Call: Hospice Care
Patients and families have choices
for care and comfort
When patients are told they likely have less than 6 months to live, hospice arrangements are usually suggested.
hospice care—either at a facility or in patients’ homes—medical
attention shifts from treating the disease to making the patients as
comfortable as possible. Quality of life becomes the ultimate concern,
and pain management and social, spiritual, and psychological support
for the patients and their families are addressed. Studies have shown
that the earlier a terminally ill patient engages in palliative care or
hospice services, the better the patient’s quality of life will be.
What is hospice care?
A typical team providing hospice care will include, at the minimum, a
physician, a nurse, and a counselor, although it may include other
health care professionals, social workers, and chaplains. Together, the
team will work to ensure that patients receive medical attention as
well as medicine required to manage pain. Hospice workers strive to
help patients reduce stress as much as possible by providing a
home-like environment or providing care in the patients’ homes.
Hospice workers address patients’ psychological, social, and spiritual
needs by providing counseling and companionship and sometimes by
helping them reminisce about the life they have lived. Combined, the
two-pronged approach of pain management and psychosocial care ensures
that patients enjoy as dignified and comfortable an end-of-life
experience as possible.
Hospice care options
Hospice programs are becoming increasingly available as awareness grows
of the benefits of attention to a patient’s comfort in his or her last
months of life. With nearly 5,000 hospice facilities in the United
States alone, patients and their families have many options for hospice
care and can select a provider that best aligns with their individual
If patients still require medical attention, it may be provided within
the hospital or in a nursing home that offers advanced medical care,
with special attention paid to maintaining their level of comfort. In
some cases, a facility specifically designed for hospice care may be
Typical facility hospice programs include:
- 24-hour medical care through one’s physician or a
specialty hospice doctor and a staff of nurses, therapists, and aides;
- easy access to various treatments or medical equipment;
- counseling services for mental well-being;
- spiritual comfort from onsite or visiting clergy;
- help for personal needs through social services; and
- visitation hours that allow family members to come at any time.
If the life-threatening disease does not require constant medical care,
patients may choose to return to their homes and receive treatment from
mobile specialists trained to provide hospice care. While in-home care
usually will not provide around-the-clock assistance, help is always
available when it is needed.
Typical in-home hospice programs include:
- in-home medical care as well as 24-hour access to nursing support;
- hospital or doctor visits as needed;
- help with getting required medical supplies or equipment;
- help with day-to-day necessities such as cooking, cleaning, or personal care;
- information for the patient’s family about how to give medical care between care team visits;
- time spent with the patient to provide family
members much-needed physical and social relief from fulltime
- counseling for both the patient and family during the illness and after the patient has died.
Each option has its merits. Choosing a hospice program should involve
identifying one that aligns with a patient’s specific needs and beliefs
as well as investigating the agency’s credentials. A patient’s
insurance coverage may affect his or her choice, but most insurance
plans and Medicaid now cover hospice care, and Medicare offers the
Medicare Hospice Benefit.
Knowing their options can help patients and their families find the hospice program that best suits their needs.
– L. Jorewicz
information, talk to your physician, visit www.mdanderson.org, call askMDAnderson at 877-632-6789, call MD Anderson’s Department of Social Work at 713-792-6195, contact the National Hospice and Palliative Care Organization at 703-837-1500 or www.nhpco.org, or contact the Hospice Foundation of America at 800-854-3402 or www.hospicefoundation.org.
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