Celebrating National Hospice/Palliative Care Month

During November, across the country, hospices are honoring patients and families coping with life-limiting illness. Hospices are recognizing the professionals and volunteers who provide high quality care to those who need it most. National Hospice Month also provides an opportunity to promote important discussions with our loved ones and our health care providers about the care we would want at the end of life. This year’s theme is "Hope, Dignity, Love…It Must Be Hospice." We would like to offer a brief overview of what hospice is, and the many benefits it offers persons with a life-limiting illness and their loved ones.

The word "hospice" comes from the same root as "hospital," "hospitality" and even "hotel"—all referring to caring for a person's comfort and needs. "Hospice care" means care provided to persons who are terminally ill. Some hospices are specialized, inpatient facilities where terminally ill patients come to stay. Hospice services may also be provided in long term care facilities or hospitals. Some hospice facilities also provide respite care, where patients can receive temporary care on an in-patient basis.

The most common providers of hospice care are home health agencies and in-home hospice services, which support persons who wish to be cared for at home.

But hospice is more than a place or agency—it is a philosophy of healthcare for persons at the end of life that seeks not to prolong life unnaturally, but to ensure that in the time left to the dying person, his or her life is as full and comfortable as possible. Hospice focuses on the dying person's quality of life and to provide support for family and other caregivers.

What Services Does Hospice Provide?

The goal of hospice care providers is to give supportive nursing care, such as...

• Palliative care aimed at relieving pain and other symptoms, such as dry or sore mouth, dizziness, or nausea. There are many ways to effectively manage pain; the hospice team works with the patient to provide the best possible symptom control.
  
  
• Other nursing care, such as blood work, mouth care, wound care, placing and maintaining catheters.
  
  
• Personal care, such as bathing, grooming, shaving, and changing bed linens.
  
  
• Social, psychological and spiritual support for the person who is at the end of life, which is just as important as physical care.
  
  
• Support for family and other caregivers who are dealing with stress, grief, and other emotions encountered in caring for a person in late-stage terminal illness. Hospice staff can guide family through daily tasks, both practical and emotional. They can provide or refer respite care. Bereavement counseling and financial guidance are also available.

Who is on the Hospice Team?

An interdisciplinary team works with the patient and family. Hospice care providers include:

• Nurses, who perform medical care procedures such as placing and maintaining catheters, wound care and blood draws. Nurses also instruct caregivers in skills needed to care for their loved one, such as routine dressing changes, administering medication, providing comfort care, and so forth. Nurses consult with the patient's physician about treatment, and commonly serve as the care team leader.
  
  
• Social workers consult with patients, families and caregivers to create and maintain a supportive care setting. They are available to help patients and families deal with personal, financial, emotional and care planning issues that arise.The social worker may:
  
  • Identify community resources and provide referrals.
  • Assist with confusing paperwork for assistance programs and insurance.
  • Help with the emotional side of the dying process.
    
    
• Occupational therapists and other therapy services help maximize the independence, quality of life and safety of patient and family. The occupational therapist can:
  
  • Visit the home to evaluate the need for medical equipment and assistive devices, such as walkers, handheld showers, portable commodes or hospital beds.
  • Help the patient and caregiver learn to safely transfer from bed to wheelchair, and demonstrate positioning in bed to prevent problems caused by immobility.
    
    
• Speech therapists can help the patient to communicate, even if he or she cannot speak.
  
  
• Home health aides are trained nursing assistants who provide personal care to the patient. They help the patient and family with activities of daily living, such as grooming, bathing, changing bed linens and skin care. Aides work closely with nurses and other hospice team members.
  
  
• Clergy members and counselors are available to help with the spiritual concerns of both patient and family, who may be struggling with end of life issues. They also offer bereavement counseling.
  
  
• Volunteers from a variety of backgrounds provide many indispensable services for hospices. Volunteers may:
  
  • Stay with the patient so the family can take a break (respite care)
  • Provide transportation to appointments or run errands.
  • Help with household tasks.
  • Provide one-to-one companionship.

The hospice philosophy acknowledges that dying is part of the normal process of living. It focuses upon filling the person's last days with as much physical, psychological and spiritual comfort as possible. The hospice philosophy embodies the belief that quality of life and dignity are important human rights—throughout a person's entire life.

For More Information about Hospice

The National Hospice and Palliative Care Organization offers information about many end of life issues, and resources for persons with terminal illness, their families and caregivers. The affiliated National Hospice Foundation offers more resources and information.