Requirements for Hospice Care

Hospice is palliative versus curative treatment for people with terminal illnesses and is a concept versus a specific "place." While most people entering hospice care choose to remain at home, there are others who are located in nursing homes or hospice-specific facilities. Hospice organizations are staffed by medical and other professionals. They assist caregivers and families facing the loss of a loved one to reconcile the loss, while caring for the "whole" of the patient.

Function

• Prior to modern medical advancements, the elderly, terminally ill and others who were facing death were cared for--and passed away--at home. The hospice concept considers death a natural part of life. It doesn't "hasten or postpone death." Because the physical, emotional, social, and economic challenges associated with dying, all involved need special attention in specific areas. The goal of hospice care is to include everyone in the process up to and beyond the death.

Requirements

• People considering hospice will have a limited life expectancy of six-months or less, and they must be referred to the program by a physician. Regardless of age or illness, hospice accepts people who have decided to stop aggressive treatment processes related to their terminal conditions and desire to spend their remaining time in their homes or similar settings. Only the patient and her doctor have to agree that this is the course to take. However, it is necessary to have others (family members and friends) "on-board" with the decision. As the disease worsens, the majority of care will be provided by the family or designated care-givers.

Considerations

• Admission to hospice involves first choosing the appropriate organization for you, which often is referred by your physician or other people in the health care or cleric community. Once the process begins, the hospice representative will validate the "life-limiting" diagnosis with the physician (as required by Medicare and insurance law), constituting admission orders. The hospice nurse will usually visit you at home and have you sign release and insurance forms; he will then make an assessment of current needs for medical equipment and medications. The nurse will make the necessary arrangements for any equipment or medication deliveries.

Benefits

• Hospice focuses on quality of life instead of quantity. When facing difficult decisions about death and dying, many find solace in the comprehensive treatment program hospice offers. There exists an interdisciplinary team, usually consisting of a medical director (M.D. or D.O.), registered nurse, licensed vocational nurse, home health/hospice aides, social worker, a chaplain and a volunteer within individual hospice organizations. This team works together with the patient, family and other caregivers offering teaching, guidance and counsel as needed. Hospice care is usually covered by private insurance and is covered fully with Medicare; however, if you do not have either, often there are community programs available to assist with funding.

Expert Insight

• Roger C. Bone, M.D., (a dying man) offers advice to the terminally ill and their families in his article "A Dying Person's Guide to Dying." He encourages them to ask questions and seek a second opinion to be sure the direction of treatment they are pursuing is accurate.