Hospice takes care of more than medication
President declares November National Hospice Month

November is National Hospice Month, a time to recognize caregivers and to raise awareness and understanding of an often-misunderstood concept.

Hospice care deals with end of life issues and how best to spend the last days of one's life. For each person who enters hospice care, and for each family member, the answer may be different.

Hospice care is for terminally ill patients and aims at palliative care and supporting the emotional and spiritual needs of the patient and the family within whatever setting is appropriate. Some family members still resist the idea of hospice care because they think it means they are giving up on their loved one.

Dr. Elisabeth Kubler-Ross is generally credited for turning that thinking around and starting the hospice movement in her book On Death and Dying.

Hospice care can begin when the patient is diagnosed with a terminal illness and has a reasonable expectation of death within six months, and the patient and family decide the goal is to provide care and comfort, not further treatment.

Traditional medicine used to encourage such patients to continue aggressive, invasive and sometimes debilitating treatments long past the time there was any possibility of a cure. Patients now are usually introduced to the idea of hospice care earlier, during informed consent discussions where treatment options are explored.

All around support

Hospice care aims to control pain and improve the quality of life for the patient and family with many different kinds of support services.

Most hospice programs do everything they can to keep the patient in the environment they prefer for as long as possible. That may be the patient's home, a nursing home or with family members.

In the early stages, a nurse may visit a few times a week to assist with medication to alleviate pain and to improve the quality of life for the patient.

As the disease progresses, hospice care can provide for other needs, including people to shop, clean house or provide meals. In the end, it may mean that a nurse remains on duty full time.

For most patients, the cost of hospice care is negligible, if any. Expenses are usually covered by Medicare and Medicaid.

Hospice services take into account the welfare of the whole family and offer family counseling at the beginning and for up to a year after a death.

Kubler-Ross defined the five stages of grief as denial, anger, bargaining, depression and acceptance. Hospice workers often spend long hours with families in the most difficult circumstances as they work their way through these stages.

In recognition of that, President G.W. Bush declared, "We recognize hospice caregivers for their dedication to providing comfort and peace to individuals in their last days and helping build a society that values the life and dignity of every person.

"Hospice physicians, nurses, counselors and volunteers bring care and support to the terminally ill through physical, psychological, social and spiritual aid... Hospice care enables many of our citizens to spend their final days in comfort and dignity surrounded by loved ones."