Hospice — full service, quality, end-of-life plan

Considering the inevitability of death we all face, Hospice patients have a unique opportunity to greet death with dignity. Hospice patients are able to leave their families and friends with positive memories.

Resources are available to help families through their grief and adjustment to life without a loved one’s presence. People are the focus of Hospice — not just the disease, not just the contributing factors, not just the consequences of medical choices, not just medications. Utmost is the physical comfort and peace of mind of the Hospice patient.

To meet Hospice criteria, a patient must have a disease that if it were to run its usual course, the patient’s expectancy would be six months or less. However, Hospice patients may remain in Hospice as long as necessary provided medical criteria are still met. Studies indicate that patients often live longer with the benefit of Hospice than those patients without Hospice services (Journal of Pain and Symptom Management; Volume 33, Issue 3; Pages 238-246, March 2007; and Journal of Pain and Symptom Management; Volume 28, Issue 3; Pages 200-210, September 2004).

While Hospice does not provide 24-hour in-home care, Hospice does have a nurse available by phone 24 hours a day and makes visits as necessary for patient comfort. Medicare and most insurance companies offer a Hospice benefit, so there is generally little to no out-of-pocket expense for the Hospice patient and family. Hospice pays for all comfort measures, all medications and all care related to the end of life diagnosis.

The Hospice patient and family assist in designing an individualized, holistic home care plan with a full range of services, including medical, emotionally supportive and spiritual realms. A nurse, specially trained in pain control and the end of life process, a medical social worker and a chaplain are core disciplines assigned to every Hospice patient and family. The patient may even retain the services of a primary care physician to work in tandem with the medical director of Hospice, who is a Hospice specialist.

Personal care aides are also available if needed. These team members all work in concert to provide physical comfort, extend mobility and provide education about all aspects of the care to be received and the end of life process. Underpinning all these services are volunteers who make wonderful visit companions and provide other assistance depending on the needs of the patient and family. If caregivers become exhausted and need a break, volunteers can stay with the patient, giving family and friends an opportunity to go out for coffee or to dinner and a movie, knowing that their loved one is in good hands.

The patient is in control as well. Patients who are able may travel. They can vacation or go camping and fishing, whatever their physical and mental abilities will allow. The patient can revoke participation in Hospice at any time for any reason and come back on at any time provided appropriate medical criteria continue to be met. The patient may even improve and move out of Hospice to Home Health Care or use no professional care at all.

It is commonly found that the earlier patients take advantage of their Hospice program, the more effective Hospice will be for them and their family in all aspects of care, as well as extending the expected length of life.

People on Hospice aren’t just dying. People on Hospice are living until they die. Hospice helps to facilitate their living.

Bernie Jarriel is the Hospice administrator at Mat-Su Regional Medical Center.