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Hospice and Palliative Care

Misconceptions about hospice can cause some to dread the entire subject.  For some, signing up for hospice is seen as giving up.

The hospice philosophy treats death as a natural part of life, suffering is not extended and doesn’t hurry the end, allowing nature to simply take it’s course with a single focus on living life to its fullest in those final days. It is a special kind of caring for dying people, their families and caregivers designed to meet their total suffering—physical, emotional, social, and spiritual—in the last days of life. Hospice feels life should be lived fully, with as much comfort and dignity as possible. Quality of life is as important as length of life, with care focused on the patient and family rather than the disease.

Hospice focuses on the alleviation of a terminally ill patient’s symptoms. It is a holistic approach involving a team of trained professionals who provide medical attention, pain management, and support personalized to an individual’s needs and wishes. Teams provide compassion, strength and comfort to grieving caregivers as well as the patient during the illness and beyond.

Hospice helps make the patient as free of pain as possible so they can make the most of each day, focusing on support of the family. Outside of the hospital, patients and families have more control over the final days. Hospice comes to the patient, wherever he or she calls home. Whether in a nursing home, home-like hospice facility, hospital, assisted living, veterans’ facility, hospital, prison, or at home, services are available wherever it is most comfortable and as long as needed, even years. Several hospices in the area have in-patient facilities.

Hospice care is covered by Medicare, Medicaid and most private insurance plans. Hospice is the only Medicare benefit that includes medications, medical equipment, 24/7 access to care and support for loved ones.

Professional staff and trained volunteers on the care team provide expert medical care and supportive services to help meet complex needs, including counseling support for families, short-term respite care, spiritual care and counseling, volunteer support, bereavement care, transitional home health care, palliative care, and end-of-life education. Physicians, spiritual care counselors, bereavement counselors, nurses, nursing assistants, clinical counselors and social workers, trained volunteers, nutritionists, physical, occupational and speech therapists are available.

The goal of hospice care is comfort rather than cure during the terminal illness. Hospice allows patients and families to decide where and how they want to spend their final days. Patients are eligible for hospice care if a doctor determines they have a life expectancy of six months or less, and are seeking comfort care rather than curative treatment.

“We provide innovative, thoughtful care, using an interdisciplinary team approach, to achieve the best possible outcomes for the patients, families and communities we serve. Hospice can bring peace for a lot of patients and their families. This is what we do each and every day, and we are good at it. The hospice team comes in and helps both patients and families come to terms with the end of life, and support them in choosing their own path,” said Diana Mitchell, MSW, Marketing Manager, Duke HomeCare & Hospice.

Hospice care and palliative care are related, but different. Palliative care is the attention to and treatment of symptoms by a professional team, with a goal to prevent and relieve suffering and improve quality of life. Hospice care is for people at the end of their lives, who will not recover. Hospice care is comfort care for the last six months of life, while palliative care can be provided at any time during an illness. Palliative care is often used when chronic diseases such as cancer, heart failure, HIV/AIDS, diabetes, or progressive neurological conditions are being treated and provides a wide range of services.

Emily Pearson, RN, Hospice Clinical Services Coordinator, 3HC, said “Dying is a natural part of life, and each person’s dying experience is unique to them. The compassion of hospice allows one to be cared for in a home setting surrounded by loved ones. When a cure isn’t possible, CARE is. Our goal is geared towards ensuring that the person is given the opportunity to live as fully and comfortably as possible, while at the same time, provide support for the caregiver as they care for their loved one in the final weeks and days of life.

Bereavement services are typically offered free to family members for up to a year or more after the patient’s death. Counselors provide compassionate counseling and support to adults and children who are preparing for, or grieving, a loss. One of the best ways to address grief issues is to talk about them with others who are also coping with the death of a loved one, individually or in a group. Adult, child and teen groups are available as well as workshops and individual counseling.

Michael Blanchard, Vice President of Development, Hospice of Wake County Foundation, told us, “To the casual observer, it might appear that the aim of hospice care is to help patients with a serious illness die peacefully. The truth of the matter is that the goal hospice is not to help anybody die, but to help patients live as fully and comfortably as possible as long as they have life. Likewise, the goal of a hospice’s bereavement program is not to help family members forget the deceased but to help them cope with loss while celebrating the lives and honoring the memories of their loved ones.”

There are many opportunities to volunteer for hospice, suitable for groups and individuals of all ages and backgrounds. Hospices need office helpers, fundraisers, family support and speaking volunteers. It is a most rewarding endeavor, paying back much more than that given.

Article by Lesley Gray
Reprinted with permission from the December 2010 edition of Boom! Magazine.

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