Hospice:
A Benefit Worth Discovering

By Lisa Butler
Director of Hospice

We frequently hear from families of hospice patients, “I don’t know what I would have done without hospice.”

Yet, even though many families touched by hospice have shared such positive experiences, hospice still remains an under-utilized service. Several factors may contribute to this issue: a natural hesitancy to acknowledge dying as part of the life cycle; a concern for the cost of care; and common misconceptions about hospice.

Hospice is a special kind of care for people facing a life-limiting illness, based on the belief that each of us has the right to die pain-free and with dignity, and that our loved ones will receive the support necessary for us to do so. Hospice emphasizes quality of life, allowing people to stay in familiar surroundings with their loved ones while receiving the care and support services they need. Hospice nurses, physicians, social workers, therapists and spiritual counselors who specialize in end-of-life care are adept at managing pain, promoting comfort, and attending to the emotional, social and spiritual needs of patients and those close to them.

The earlier hospice is involved, the more likely it is that a patient’s final days, weeks or months can be comfortable and fulfilling. Patients may find that because their pain and symptoms are managed so effectively, they are able to maintain many of their current daily activities and hobbies. They often can engage in a wide range of meaningful activities to gain closure in their lives. Such activities may include sharing life stories, traveling, putting affairs in order, and maintaining or re-establishing connections with family or friends.

Hospice services are covered under the Medicare Hospice Benefit, the Medicaid Hospice Benefit, and by most private insurers. Most of the services under the Medicare and Medicaid Hospice Benefits are fully covered. Services include: physician services, nursing, social services,
spiritual counseling, medical equipment and supplies, drugs, short-term respite and inpatient care, therapy, and bereavement services.

For those without coverage, hospices will generally offer charitable care to ensure needed services are provided. Hospice agencies have staff available that will help explain coverage to the patient and their family members.

Did you know?

You may keep your primary physician if you start hospice. The primary physician often provides the initial diagnosis and referral and may stay involved throughout your care, working collaboratively with the hospice medical director to coordinate medical care.

• Hospice staff visit the home or residence to provide care on an intermittent basis, based on individual care needs. Hospice nursing services are available for consultation around-the-clock, and will visit the patient as needed to manage the patient’s care.

• You can still have hospice services if you are living alone. As long as you are able to safely care for yourself and meet your needs, you can remain in your home. As your needs change, hospice staff can help you find caregivers or arrange alternative living arrangements.

• You do not have to be classified as Do Not Resuscitate (DNR) to receive hospice care. The focus of the hospice plan of care is self-directed life closure, not hospice-directed life closure.

• Hospice does not hasten death or prolong life. Hospice provides its presence and specialized knowledge to ensure that patients experience the best quality of life possible.

• Spiritual counselors and bereavement services are available to your family as part of the hospice benefit. Hospice programs have a broad definition of family,
  viewing friends, neighbors and caregivers as part of the family unit.

You and your family should feel free to discuss hospice care with your physician during the course of a life-limiting illness. For additional information about hospice, visit The National Hospice and Palliative Care Organization website (www.nhpco.org) or the Washington State Hospice and Palliative Care Organization website (www.wshpco.org). Click on Find a Provider to locate a hospice in your area.

Lisa Butler, MN, RN, BC, has 20 years of hospice and home health experience and has served as Director of Hospice at Providence SoundHomeCare and Hospice for 8 years. She may be contacted at lisa.butler@providence.org.

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