St. Gabriel's Hospice and Palliative Care

When is Hospice Care Appropriate?

Hospice is not a particular place, but it is a service available to patients of any age, religion or race who  are dealing with any terminal illness such as cancer, HIV/AIDS, neuro-muscular diseases, etc.  Hospice care provides end-of-life care and support, most often in the patient's home.  In fact, 70% of hospice care takes place where the patient lives.  

When hospice care is initiated, a hospice team will craft a care plan that will comprehensively meet the needs of the patient.  Typically, a family member will serve as the primary caregiver who can make decisions for the terminally-ill person.

But the question arises:  When is it appropriate to seek hospice care?   To begin with, clear-cut eligibility requirements must be in place for hospice care to take place.  To elect hospice care under Medicare:

1.  An individual must be entitled to Part A of Medicare

2.  An individual must be certified as terminally ill by a physician and a hospice medical director

3.  An individual must have a prognosis of 6 months, or less, to live – this assumes the illness or disease will run its expected course.

Eighty percent of people who use hospice care are over the age of 65 and qualify for the services provided by the Medicare Hospice Benefit.  Most private health plans and Medicaid in 48 states and the District of Columbia cover hospice services.

Cure Vs. Care
Hospice care is appropriate for, and designed for, those who are willing to stop all disease-fighting treatments which would include chemotherapy and radiation and other medical treatments.  Though hospice is, indeed, befitting for many who are dealing with terminal conditions, it would not be well-suited for those who are not comfortable with, or able to be a part of, the dying process.  When 'cure, cure, cure' becomes the all-encompassing mindset, in spite of a medical prognosis of 6 months or less to live, facing the reality of death is, often, unacceptable to many; and denying it can feel somewhat comforting.  If someone, however, is willing to move the conversation from 'finding a cure' to 'living the best quality of life with the time left', then hospice care can become the focus.

The services associated with hospice care can manage an individual's symptoms to allow the last days to be lived with dignity.  Hospice care enriches the emotional well-being of the patient and provides an enlarged circle of support for a patient's family and friends.   In spite of the benefits of hospice care, a person with a terminal cancer, for example, may resist hospice care and equate it with 'giving up'; but it is important to realize that if that cancer patient is enrolled in hospice care and the cancer goes into remission, one can exit the hospice program, at any time.  Additionally, one can re-enter hospice care, later, if so desired.   

Hospice care is not about curing, but about caring – it passionately focuses on the quality of life one has left.  Hospice affirms life and, neither, hastens nor postpones death.  Hospice treats the person rather than the disease. Rather than focusing on the length of life, hospice care focuses on the quality of life.    

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