HOSPICE CARE: Making an Informed Choice

By Burnham, Richard | USA TODAY, March 1999 | Go to article overview

HOSPICE CARE: Making an Informed Choice


Burnham, Richard, USA TODAY


"Through understanding, recognition, and acceptance of hospice care, those diagnosed with a terminal illness have a favorable alternative when curative treatment no longer is an option."

Over the past 100 years, the 65-plus age group has increased twelvefold, with the 85-plus age group the fastest-growing population segment. The U.S. Census Bureau estimates that, by 2050, the 65-plus segment will double, reaching 67,000,000, or 21.8% of the U.S. population. With this graying of America, hospice care has become a $2,200,000,000 industry, playing a role in some of the most significant and cost-saving marketplace changes, including a rise in the number of mergers and acquisitions. This tremendous surge is a result of society recognizing the validity of palliative care as the chief option when curative treatment no longer is appropriate.

What is palliative care? For centuries, a hospice was a place of shelter for weakened and ill travelers to reside. Over the years, it evolved into a refuge where people could find care, comfort, and support during difficult times in their journey through life. Today, a simple summation of palliative care--also referred to as "end of life" or hospice care--is that it is designed to provide aggressive treatment of physical and emotional pain and symptoms for persons in the last phases of an incurable disease.

To raise awareness and understanding, as well as to clarify numerous misconceptions of hospice care, certain factors should be reviewed in order to make informed decisions. These include:

* What criteria are necessary to be eligible for hospice services?

* What services are available to the patient and family, and how does a patient acquire them?

* How do hospice services differ from those in a nursing home, home health, or assisted living setting?

* How does a patient pay for hospice services and what benefits are covered under Medicare, Medicaid, or private insurance?

In order to be eligible for hospice services, the following criteria must be established: The patient and his or her physician must decide that curative treatment no longer can be of benefit. Moreover, the patient must have a short-term life expectancy.

Once the decision has been made that curative treatment is not an option, hospice care is discussed and agreed upon by the patient, the physician, and a hospice team doctor. The hospice team then will lead the patient and family step-by-step through an evaluation process, providing assistance for any concerns and explaining the services provided, including medical staff (nurses, doctors, etc.); medication, equipment, and supplies; personal care (bathing, feeding, and dressing); housekeeping and assistance with daily living; emotional, financial, and spiritual counseling; physical, speech, and occupational therapies; and volunteer services and support. Through these services for the patient and family, the palliative care provider can improve the patient's quality of life and focus on the enhancement of comfort.

Hospice takes the place of acute level care over a wide range of diagnoses, including AIDS; Alzheimer's disease; cancer; cardiovascular, cerebrovascular, and chronic obstructive pulmonary disease; congestive heart failure; and gastrointestinal, liver, and renal disease. …

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