What is hospice care?
Hospice care is for people who can no longer benefit from regular medical treatment and are likely in their final months of life. The goal of hospice is to keep pain and suffering to a minimum, not to cure the underlying illness. For both you and the person in your care, this requires a shift in mindset from searching for a treatment that will restore health to accepting that comfort, dignity, pain relief, and privacy are prime concerns toward the end of life.
How hospice care works
Like most people, you may think of hospice as care received at home -- which is often the case. But someone can also receive this end-of-life care in a hospital, nursing home, or private hospice facility. Which is best depends on a patient's physical condition, whether the home is suited to providing hospice care, and the resources available in your community,
Hospice care isn't necessarily continuous, and a patient may switch into and out of it as a medical condition improves or deteriorates. For example, if a patient is in hospice care and goes into remission -- a period of relief from the symptoms of an illness -- the hospice care can be stopped, only to be resumed again if the symptoms reoccur or the condition gets worse.
The entree to hospice care usually comes from a diagnosis and realization: To qualify for most hospice care, a doctor must diagnose a patient with a terminal illness -- that is, a medical condition that may cause death within six months or less.
Getting hospice help
You may find that you need to use some steely persistence to get the mechanics of hospice care initiated, both in dealing with attending physicians and in finding a hospice organization willing and available to provide the needed care.
For one thing, hospice workers can't step in until they have a written referral from a physician. In addition, you'll have to locate hospice providers and make sure they're willing and able to help. In spite of the role hospice plays, it can sometimes take some lobbying to gain admittance to a hospice facility. For instance, if the facility thinks a patient might be too much of a handful (has a tendency to run off, for example), you may need to convince the staff that you'll visit and help regularly, if not daily.
The initial hospice meeting
During an initial orientation meeting, hospice workers meet with you, the patient, and interested family members to assess the plan of care. If you'll be providing care at home, the orientation workers will evaluate whether the place needs to be equipped with any special gear, such as an elevating hospital bed, a pad to help prevent bedsores, protective coverings for the floor, or ramps for a wheelchair. They may also investigate details ranging from the neighbors to the nearby barking dogs to the number of steps in the patient's house.
History of the Hospice Movement The word 'hospice' was first used from the 4th century when Christian orders welcomed travellers, the sick and those in many kinds of need. It was first applied to the care of dying patients by Mme Jeanne Garnier who founded the Dames de Calaire in Lyon, France, in 1842. The name was next introduced by the Irish Sisters of Charity when they opened Our Lady's Hospice in Dublin in 1879 and St Joseph's Hospice in Hackney, London(1905). Dame Cicely Saunders' experiences while working at St Joseph's and at St Luke's Hospital (Home for the Dying Poor founded in 1893) led to the founding by her of St Christopher's Hospice in 1967. Two national charitable organisations, Marie Curie Cancer Care and The Sue Ryder Foundation have also played an important role in providing specialised care for dying people and their families. The 11 Marie Curie Homes were developed in the 1950s and the Sue Ryder Homes began to emerge in the 1970s. The growth pattern of hospices in recent years has been considerable. In the first few years after the opening of St Christopher's development was mainly in the independent, charitable sector. In the early 1970s the National Society for Cancer Relief (now known as Macmillan Cancer Relief) began a programme whereby capital grants were given to units built within NHS hospital grounds with health authorities taking over responsibility for their running costs. Hospices and palliative care have developed in different ways, appropriate to the needs of patient and family - inpatient care, home care, day care and hospital services. The different categories of patient care provided by hospices and palliative care centres are as follows: Independent or Voluntary Hospices - these units are registered charities financed mainly by charitable income. They have firm links in policy and practice with the National Health Service but receive only partial funding from health authorities. In addition to inpatient care most hospices provide home care, day services and bereevment support. Some buildings are purpose built, while others may have been established in a converted building. Units range in size from 2 to 63. Marie Curie Centres are administered by a national charity, Marie Curie Cancer Care. In addition to 11 homes there are 6000 part-time Marie Curie Nurses who nurse patients in their own homes. Sue Ryder Homes administered by the national charity, the Sue Ryder Foundation, provide palliative care for patients with cancer in all of their homes, and several have visiting nurses who attend patients in their own homes, both before admission and after returning home. Macmillan Cancer Care Units. Macmillan Cancer Relief has funded and built many inpatient and day patient units, mostly on hospital sites and now being funded and operated by the National Health Service. Macmillan has also funded, or part funded, several units operated by the voluntary sector. Palliative Care Wards/Units in NHS Hospitals. Some hospitals have designated units or wards where patients benefit from the principles and practice of hospice care.
Most hospice care is 100% paid for by medicare or insurance or indigent care. No charges are ever made to patients or familys. Hospice is very easy to obtain, a verbal from any doctor is all that is required. Most patients do not require major equipment and can be cared for at home. Hospice providers are very easily found by your local doctor or nursing home staff or phone book. They are always happy to help or can find someone who can. Thank you- Hospice RN
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This is good hospice information. My partner's mother (90) is in hospice care at an assisted living facility. She has good days and bad days: sometimes the end is in sight, then she revives. But I get good info from caring.com, and it is useful in writing my weekly senior column for a local newspaper. Thanks, Judy
These pages are some of the most valuable information I have found. It is clear and concise. Thank you!