Understanding Hospice Care

Hospice services can be a tremendous source of support and comfort as an older adult nears the end of their life journey. Caregivers may be reluctant to initiate hospice services because they associate doing so with “giving up.” Fortunately, this is far from the truth. Hospice services are focused on improving the quality of life both for the person with an illness and their loved ones. An experienced hospice service provider can guide and comfort the older adult and their family members in very valuable ways.

Hospice care is considered the model for quality, compassionate care for people facing a life-limiting illness with a prognosis of six months or less. However, care does not necessarily end after six months. Hospice takes a team-oriented approach to providing expert medical care, pain and symptom management, and emotional and spiritual support tailored to the person’s needs and wishes. Support is also provided to the individual’s family.

The focus of hospice is founded on the belief that each person has the right to die pain-free, with dignity and at peace, and that their loved ones should receive the support necessary to allow them to do so. Hospice focuses on quality of life, not curing.

Generally, hospice is recommended when the person is expected to live six months or less. A referral to a hospice provider from the individual’s physician is required to begin care. Except for restrictions set continued

by an insurance provider, the selection of a hospice service provider is a personal choice.

Once the referral is received, hospice staff will visit with the individual and family to assess their overall needs and wishes. Hospice consists of an interdisciplinary care team that includes the individual and the primary caregiver, as well as physicians, nurses, hospice aides, social workers, chaplains, various therapists, and trained volunteers.

The care team works together to create a care plan specifically tailored to meet the needs and desires of the individual and the family. Among its major responsibilities, the hospice care team:

Manages the person’s pain and symptoms – referred to as palliative care Provides emotional support

Provides needed medications, medical supplies, and equipment related to managing the life-limiting illness

Inquires about end-of-life wishes, advanced directives and a do not resuscitate (DNR) order

Coaches loved ones on how to care for the person

Delivers special services like speech, occupational, and physical therapies as needed

Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home or the caregiver needs respite

Provides grief support for surviving loved ones and friends

As you consider beginning hospice care, it is also a good idea to consider the person’s end-of-life wishes and to choose a funeral, burial or cremation provider. You’ll also need to include this information in your hospice care plan.

A DNR is a medical order that allows individuals to state their desire not to be resuscitated in the event that they stop breathing or their heart stops. It is usually made by the individual or their healthcare proxy. This gives medical personnel and family members clear instructions about how such situations should be handled so that the person’s wishes can be respected. The individual or their healthcare proxy can change or revoke an advanced directive or DNR at any time by simply informing the physician or hospice staff.

Hospice services most often are provided in the recipient’s own home, but can also be provided in a long-term care or assisted living facility, a family member’s home, or special end-of-life care facility. For a hospice care agency evaluation checklist, see page 39.

In Oklahoma, besides private pay, hospice care can also be paid for by Medicare (Part A), the Veterans Administration, most private health insurance plans or the ADvantage program. If none of these payment sources are available to the patient, some hospices do provide courtesy care. Ask your healthcare provider or resource counselor which hospices provide courtesy care.