Misconceptions of Hospice Care
Unfortunately, the word hospice in itself is surrounded by both mystery and misconception. Often misunderstood, hospice has been viewed as a place where patients go to die. It has been assumed that all treatment is stopped, and a DNR and absolute certainty of the diagnosis are required.
The reality of a progressive and highly symptomatic terminal illness leaves most patients and healthcare providers uncomfortable to varying degrees. The intent of the Medicare hospice benefit is also oftentimes misunderstood.
Realities of Hospice Care
The purpose of the Medicare hospice benefit is to provide all healthcare needs to a vulnerable population, while assisting in preventing overuse of the emergency departments and hospitals nearing the death of a patient. The reality is that hospice is a philosophy of care designed for patients who are suffering from terminal illnesses and who are entering the last six months of their life. Hospice is not actually a place, but instead, it is a set of services offered to patients in whatever setting or space that they call home.
As opposed to overly aggressive, disease-modifying therapy, which too often comes at the expense of quality of life, hospice patients have made the decision to pursue a symptom-oriented approach to care. Hospice care is provided by an interdisciplinary team with the patient and their loved ones at the center of its focus. The priority is expert management of distressing the physical, emotional and spiritual symptoms a patient is experiencing.
Hospice provides all of the medications and services related to the terminal prognosis, including home visits from a physician for the management of the patient’s symptoms. A patient who has opted to receive hospice care has multiple visits each week from various experts in different disciplines. The goals of care are addressed and symptoms are managed appropriately. After the patient dies, no matter the length of their enrollment, the family members are provided access to hospice bereavement services for at least a year.