There are many misconceptions about hospice, and these misconceptions deprive people from the compassionate services that Hospice provides to dying patients and their family members. Few things in life are guaranteed, but everyone is absolutely guaranteed to die at some point. Modern medicine has not eliminated death, it has only changed the length and quality of our lives. Hospice improves the quality and dignity of our deaths and helps us to retain our dignity in the process. I will explain how it does that, but first lets discuss what hospice isn’t and eliminate the many misconceptions about it.
Hospice is NOT about “giving up”.
Hospice is NOT about “letting people die”.
Hospice is NOT about “giving up the fight”.
Hospice does NOT require that all medical care be stopped.
Hospice does NOT accelerate death.
Hospice does NOT euthanize (*mercy kill”) anyone.
Hospice is NOT prohibited by any religion.
Hospice is NOT a place where you go to die.
Hospice is NOT a home health aid service.
So, what is Hospice? Hospice is a medical program that is available to patients whose medical conditions are likely to end their lives within 6 months. The goal of hospice is to eliminate treatments and medications that are not improving the quality of patients’ remaining life, to control pain and other uncomfortable symptoms, and to provide medications, services and therapies that improve the patient’s happiness and comfort (i.e. pet therapy, music, spiritual care, massage, reiki), meditation). For example, if a patient is dying of advanced and incurable cancer, then that patient is not benefiting from medications that are intended to extend the lives of otherwise healthy people i.e. cholesterol lowering drugs, aspirin, or bone strengthening drugs. This patient may have pain that their primary care doctor is unable to relieve – hospice physicians are experts at pain control.
Hospice is available to patients who are actively dying, or who have accepted that they are likely to die within 6 months. Many patents have accepted that they are going to die, and prefer to spend their remaining time at home in familiar surroundings and with people they love rather than in a hospital. Many of these patients enter hospice extremely uncomfortable from aggressive chemotherapies, radiation, and surgical procedures and don’t want to continue them. Electing to begin hospice allows patients to go home, eat what they want, wear what they want, and focus on happiness rather than pursuit of a painful or futile cure.
If a hospice patient develops a medical condition that is unrelated to their hospice qualifying condition and which is uncomfortable, they can still pursue medical treatment. For example, if a patient is on hospice for end stage heart failure, but develops a tooth ache, or falls and breaks an arm, or gets pneumonia, they can go to a dentist, a done doctor, or get antibiotics.
Patients are eligible for hospice if a physician certifies that their medical condition is likely to end their lives within 6 months (a “hospice qualifying condition”). If patients live beyond 6 months (and many do), then hospice services are simply extended. If patients recover from their medical condition, hospice is discontinued. If patients would like to resume their pursuit of a cure for their disease, patients can be discharged from hospice. Patients can re-enter hospice again later if their hospice qualifying medical condition progresses and they choose to resume hospice.
Hospice is a service that is paid for by Medicare and administered by private hospice service organizations that bill Medicare directly, so patients never see any bill. Hospice services pay for all approved medications and care.