Hospice: What is it and when is it for you?


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Hospice is available across the U.S. for patients with a terminal illness, usually with no out-of-pocket costs

Many patients do not start getting hospice services until their last days of life, missing out on potentially months of support

CNN —  

Most of us would prefer to put the thought of hospice and end-of-life care as far out of our minds as possible.

True, the health problems that make a person need hospice care – terminal illness — are never reason to celebrate. “[But] hospice is not about giving up. It’s about living as fully as possible with your condition,” said Jon Radulovic, a spokesperson for the National Hospice and Palliative Care Organization, a nonprofit membership organization made up of hospices and hospice providers.

The best time to think about hospice care is after you or a loved one receives a serious medical diagnosis, Radulovic said, thinking of “what priorities are important and what options might be available.”

The family of Bobbi Kristina Brown, the 22-year-old daughter of Bobby Brown and the late Whitney Houston, had to make these decisions when she was found unconscious in a bathtub in January. Bobbi Kristina was moved into an Atlanta-area hospice facility in June. She died on July 26, a representative of the Houston family said in a statement.

In most cases, patients and their families have the benefit of time, often years, to plan for their last months of life and whether hospice care is right for them, Radulovic said.

Hospice care focuses on pain relief and symptom control for patients, usually in their own home. “The goal is really to help people get home,” which is where seven out of 10 Americans say they would prefer to die, Radulovic said. The hospice team, which includes doctors, nurses, social workers and other health care professionals, also provides support for their family and caregivers.

Research backs up the benefits of hospice. One study found that talking about end-of-life care with doctors led to earlier patient enrollment in hospice, which in turn was associated with better quality of life. “These discussions improve outcomes and do not hamper hope,” Radulovic said.

Hospice can help anyone with a life-limiting disease

Anyone can get hospice care if they have a terminal illness and their doctors think they will not live more than six months without life-prolonging medicine, the treatments that keep patients alive but do not cure them.

Although the program treated mostly cancer patients in its early days in the 1970s, the majority (64%) of its patients today have a non-cancer terminal illness, such as dementia, heart disease, lung disease or other life-limiting medical conditions. The program cares for people of all ages. A doctor needs to certify that a patient qualifies for hospice care.

Hospice puts no clock on the length of care.

If a patient lives longer than the six months their doctors expected, they can keep receiving hospice care. As long as they still have a terminal illness, and their prognosis is still six months or less, they would not get kicked out of the program. However, if a patient’s condition improves, they may no longer be eligible.

Hospice patients usually pay nothing

Hospice care is usually completely covered by Medicare, Medicaid and private insurance, Radulovic said. Some hospice programs ask for a $5 co-pay for medications but most do not, he added.

For the minority of Americans who do not have health insurance, “most hospice programs won’t turn anyone away,” Radulovic said, adding that these programs cover uninsured patients through donations from the community.

Hospice is not just for the brink of death

Although hospice is designed to help patients in their last months of life, many die shortly after they enter the program and only get days of support. A third of hospice patients die or are discharged within a week of being admitted into the program, Radulovic said. “When you only have care for a couple of days, it is hard for the patient and their family to benefit fully,” he said. Patients are usually discharged because they want to live with family in another area or their condition stabilizes, Radulovic said.

Hospice is everywhere in the United States

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