Considering Hospice Care

We cannot escape the natural process of our body. We know that soon, we will become weak and fragile. Aging is the natural effect of the passage of time on human body. Many of us want to fight our age. Most of us want to spend more time with loved ones, some of us may want to look young, some want to continue to be active and animated, others want to work more. But if our body wants to rest we cannot decline or refuse.

hospiceAside from natural aging, Sickness also is one of the factors why our body is deteriorating. Sickness is may be avoided, but it is also inevitable. We cannot predict when it will strike us, and the worst type of sicknesses are those that take longer to cure, or stays with us forever. These ailments are made easier knowing that we can get hospice care.

Hospice care is a program that we can consider if we need help to lighten up our burden in terms of health problems. This program focuses on the quality rather than length of life. It offers humane and compassionate care for people who are in the last stages of their lives. They treat the person rather than the disease so that the person’s last day may be spent with dignity, comfortably and quality. We think about hospice care if the person is no longer capable of being helped by a medicinal treatment. It aims to improve the quality of our life. It also provides support for the patient’s emotional and spiritual needs.

Therefore, we should sometimes consider hospice care. We should not think that being in the hospice program is a sign of giving up of one’s self. Let us also think the benefits that we can receive from the program. The hope that we can receive from them is the hope of quality life, making the best of each day during the last-stage of our lives. We should be thankful that there are people who offer themselves to help us feel valued and important.

Hospice Care and How It Can Help

DLS1We need all the comfort and support we can get if we are going through a life-limiting illness or if a loved one is in the last stages of a serious illness. Everyone deserves the right to die pain-free and with dignity, to live each day as fully as possible. And the family also deserves the necessary support when a member is terminally ill.

In this stage of a person’s life, a specialized care designed to provide support by a team of healthcare professionals who maximize comfort by reducing pain and addressing physical, psychological, social and spiritual needs is on option. This specialized care is called hospice care which focuses on caring and not curing.

In a hospice care, the interdisciplinary team provides the following services: manages the patient’s pain and symptoms, assists the patient with the emotional and psychosocial and spiritual aspects of dying, provides needed drugs, medical supplies, and equipment, coaches the family on how to care for the patient, delivers special services like speech and physical therapy when needed, makes short-term care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time, and provides bereavement care and counseling to surviving families and friends.

Most hospice care is provided at home. Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the person who is terminally ill. Aside from the primary caregiver, the hospice care team is composed of the patient’s personal physician, hospice physician, nurses, home health aides, social workers, clergy or other counselors, trained volunteers, and speech, physical, and occupational therapist if needed.

Dying does not need to be painful and emotionally hurtful. The goal of hospice care is to support the highest quality of life possible for whatever time remains. It affirms life and views death as a natural process.


One of the greatest fears widely expressed by the Americans is dying in pain. This is where the importance of hospice care takes into place. Hospices provide care for terminally ill patients until their last breath. They partner with health care professionals to provide the needed care in different places. While there are facilities that concentrate on hospice care, majority of these professionals come to patient’s homes.  Hospice care’s main goal is to provide dignity, respect, and care to alleviate any form of pain felt during the end-of-life journey.

hospice careA lot of people think that hospice centers let patients die alone not being surrounded by loved ones. They feel that death in such facilities is without privacy, self-worth, and that personal, religious, cultural, or spiritual request are neglected. This is the underlying reason what research say that 80% of Americans would not consider this type of care for last minute concerns.

How can the situation be improved? There should be proper awareness of hospice care in the society. By improving people’s understanding of this end of life care option, additional support would be gained. In addition, the public must realize the importance of this care and more training is needed to improve hospice care.

Local hospices could also take action in improving the situation by outreach programs within their local communities, offering free home and day services. Such activity would raise the community’s awareness and take off the misconceptions.

As the elderly population in the U.S. increases rapidly, the more we need hospice care. The decisions about death and dying should not be avoided, it should be faced and planned ahead. By preparing for legal and financial preparations, both patients and their loved ones would be alleviated with the pain associated in this unique life-to-end journey.

Hospice Care Experience

The stained-glass wall in the church of the Community Hospice House represents a menagerie of animals quietly experiencing the woodlands, water and air. It’s a field full of life. And life is the focus in this place where individuals come to die. Dee Pringle’s spouse, Gene, spent his last two weeks of life here four years ago. Her spouse had ALS (Lou Gehrig’s Disease) and was getting treatment at Dartmouth-Hitchcock Medical Center. Dee, a retired instructor who lives in Amherst, was looking after him in their house. “And I was excellent,” she said. “I was really excellent.”

hospicecareBut as Gene’s illness developed, his physicians suggested hospice care. For three months, hospice nursing staff offered support and proper care to Gene at home. Then they suggested a move to the 10-bed hospice house run by Home Health & Hospice Care, a charitable organization in Merrimack. And just like that, the pressure of medical care moved to the professionals, Pringle said. “My part was just to be with him.” She calls it “magical.””Those last few days that are valuable, the medical parts are being taken care of and you don’t even have to think about that because the qualified individuals have taken over.” It was also a great comfort to her spouse, she said. “He could rest. “Pringle can’t say enough about the services offered at the property, from food supervisors who serve residents’ wants and needs, to visits from musicians, therapy dogs and Reiki massage treatment practitioners.

She still gets together with members of a bereavement support team she met after her spouse’s death and visits some of the per month academic programs the organization offers. Her son, Frank, said having the professional employees at the hospice house take over the medical care of his dad in his last days was a convenience to the entire family. Home Health & Hospice Care has its origins in a women’s organization that took care of sick employees and their children in Nashua in the late Nineteenth century. The Good Cheer Society became one of the first viewing health professional organizations in the country.

Hospice Care and the Medical Marijuana Bill

Though medicinal marijuana will soon be lawful in certain states, physicians say it will have little to no effect on their day-to-day functions. Whether dealing with sufferers in hospice care or those with HIV or AIDS, hospice care providers do not see marijuana becoming one of their go-to medication. Barbara Lafrante, a health professional and director of hospice and palliative care with Home Health & Hospice in Merrimack, said there are already drugs on the market that provide the same advantages that marijuana is said to have. Lafrante, who rests on the New Hampshire Hospice and Palliative Care Association, recommended “Marinol,” an artificial cannibanoid, which provides identical outcomes. She said most physicians will convert to that medication because it has been approved by the U.S. Food and Drug Administration.

“We have a lot of drugs currently, you know, that we use to provide control for our sufferers,” Lafrante said. “Our sufferers are well-palliated when we use Marinol, an FDA-approved type. And we hardly ever need that.” In an organization where Lafrante said she recognizes about 80 to 100 sufferers weekly with six months or less to live, Home Health & Hospice’s guarantee is to remove the discomfort within 48 hours. “Comfort is the concern,” she said. Wendy LeBlanc, vice chairman of the Southern New Hampshire HIV/AIDS Task Force based in Nashua, said this bill will have little effect on individuals she works with, as well. Using marijuana to fight the devastating outcomes of AIDS is less common than it once was, LeBlanc said. And thanks to new medication and therapies, many HIV and AIDS sufferers do not get as fed up as they once did and some of the drugs used to cure the illness do not come with the same side-effects, like nausea and fatigue, she included.

hospicecare“It was much more commonly known and approved because individuals did not have a hunger and it certainly assisted,” she said. “Traditional drugs have enhanced for individuals living with HIV, especially for individuals clinically diagnosed more recently.” Dr. Karen Baranowski, president and CEO of Home Health & Hospice said for her, the choice to recommend sufferers marijuana is up to their physicians, but she did not see that becoming a large source for them in the long run. “If it’s appropriate for the individual, they will use the FDA Marinol more regularly, I would think about,” she said. People who do depend on the drug often hesitate to discuss it, LeBlanc outlined. The discussion is even restricted among physicians and medical employees. LeBlanc said she knows of just two individuals who recognize using marijuana to help fight their signs.

The Move to Hospice Care

Although most individuals would want to die quietly in a relaxed establishment, a new research reveals that almost one in three spend some time in the intensive-care unit of a hospital in their last month of life, while a similar number only get hospice care a few days before passing away. And 40 percent of those late hospice care recommendations come right after an ICU stay, the researchers mentioned. “People end up with these very brief stays in hospice care,” said research writer Dr. Joan Teno, a lecturer of health services, plan and practice at Brown University’s Warren Alpert Medical School, in Providence, R.I. “Those brief stays are difficult on the sufferers and the family members. They don’t benefit from hospice’s psychosocial assistance for sufferers and their loved ones.”


Another professional put it this way: “I think what has occurred is that we’re using hospice care as a last resort. It’s something we do when individuals have gotten so bad that they can’t reply to any possible involvement,” said Dr. Mary Tinetti, chief of geriatrics and lecturer of internal medicine and public health at the Yale University School of Medicine and Yale New Haven Hospital. “Hospice care should be used as a treatment for those who are targeted on total well being,” said Tinetti, who is also the co-author of an article associated with the research. “Some individuals are going to want to have access to modern care prior to the process.”

The research analyzed a unique sample of 20 % of fee-for-service Medicare recipients who passed away in 2000, 2005 and 2009. Each year, fewer individuals passed away in the medical center, according to the research. In 2000, 32.6 % passed away in the medical center. In 2005, 26.9 % passed away under hospice care and 24.6 % did so during 2009. At one time, however, the use of the intensive-care unit in the last 30 days of life increased for every time frame. In 2000, 24.3 % of individuals were in the ICU in their last month. By 2005, that number was 26.3 %, and during 2009, it had increased to 29.2 %.

Hospice Care Costs on Dementia

The RAND Corporation conducted a new study that set off a few red flames about the increasing cost of dementia within the U.S. healthcare system. According to RAND, dementia is one of the nation’s most expensive health conditions, charging the U.S. between $157 billion dollars and $215 billion dollars a year in health care and other expenses.

Compared to other common costly illnesses, the immediate healthcare expenses of treating dementia, approximated at $109 billion dollars in 2010, are in line with cardiovascular disease ($102 billion) and considerably greater than cancer ($72 billion). Beyond immediate healthcare expenses, it is approximated that an additional $48 to $106 billion dollars is spent on the unofficial care for dementia, which primarily includes lost wages and care provided by close relatives at home. The estimated growth is also eye opening, both the expenses and the number of individuals with dementia will more than double within 30 years, a rate that overrules many other serious illnesses. These incredible researches clearly strengthen the need for the U.S. to find better solutions for those suffering from dementia.


Medical health insurance rules require a doctor to approve that an individual coming into a hospital is likely to die within six months or less. Physicians are much more likely to do so when the disease is cancer or heart failure. As a result, too many sufferers are declined access to hospice care, which provides modern care (i.e. comfort care) for the dying and support for their family members. Without hospice care, those being affected by dementia may be exposed to several hospitalizations, obtrusive treatments and poor pain /symptom management.

Today, dementia sufferers are blatantly under served as less than 10% of people dying of dementia receive hospice care and often times are registered too late, within a few weeks of death. Relatively, more than 40% of People in America who die each year are in hospice care. The decision to put a loved one into hospice is without doubt one of life’s most difficult choices. But, better prognoses and education about the benefits of hospice may reduce struggling and needless medical costs.

Population Increase in Hospice Care

Many individuals are still passing away in hospitals, despite the fact that there has been a loss of the variety of sufferers who spend their final days in a setting that most would rather avoid, a new government review reveals. While the variety of individuals admitted to U.S. medical facilities improved 11 % between 2000 and 2010, going from 31.7 million to 35.1 million, the variety of individuals who passed away in medical facilities decreased 8 %, from 776,000 to 715,000, according to the U.S. Centers for Disease Control and Prevention. The fall in medical center fatalities happened mostly among females, the researchers found.

hospice_care“That could just be that there were older women who were able to be placed in alternative configurations, because women live longer. That is just a speculation,” said review writer Margaret Jean Hall, from the CDC’s National Center for Health Statistics (NCHS). Overall, the in-hospital loss of life amount is 20 % lower for individuals who die from their clinically diagnosed disease, Hall said. For some circumstances, however, the decline is even greater. For example, the in-hospital loss of life amount is down 65 % for kidney disease, 46 % for cancer and 27 % for stroke, Hall mentioned.

Many sufferers could be going to hospice care or to long-term care features, Hall recommended. “But these solutions are less extreme and maybe nearer to a setting that would be much better than the high-tech medical center,” she described. The one area where the in-hospital loss of life rate has improved engaged cases of life-threatening blood infections, moving 17 percent from 2000 to 2010. Whether these infections developed in the medical center is not known because the review only offers with the circumstances sufferers were clinically identified as having when they were admitted to the medical center, Hall said.

Qualifying Hospice Care

Many people who are critically ill delay coming into hospice care until just a few days or even weeks before they die, in part because they or their loved ones don’t want to admit that there’s no hope for a cure. “It’s a hard decision to say yes to,” says Jeanne Dennis, senior V. P. at the Visiting Nurse Service of New York are able to, which provides hospice care to 900 sufferers daily, among other services. “Everybody knows it means you’re not going to get better.” A latest research released in the publication Health Affairs discovered that there may be another reason that sufferers don’t take advantage of the comprehensive solutions that hospice care provides: limited registration guidelines that may prevent sufferers from signing up.

The study of nearly 600 hospices nationwide discovered that 78 % had registration guidelines that might limit individual access to care, especially for those with high-cost healthcare needs. The guidelines included prohibitions on applying sufferers who are palliative radiation or blood transfusions or who are being fed intravenously. Medicare will pay the majority of hospice bills, and authorities have raised concerns in latest times about possible neglect of federal funds. Eighty-three % of hospice sufferers are 65 or older, according to the National Hospice and Palliative Care Organization.

Holding Hands with Elderly Patient

To be eligible for a hospice care under Medical health insurance coverage, an individual’s doctor and a hospice healthcare home must approve that the affected person has six months or less to live. Patients must also agree not to seek healing care. Once an individual selects to enter hospice, the benefits include therapy for non-curative requirements such as pain and symptom management as well as emotional and religious support for sufferers and their loved ones. Most sufferers get hospice care at home. The Health Affairs research points out that some therapies typically considered healing also may be used to manage the symptoms of a dying individual. For example, someone might get radiation therapies to shrink a tumor to make breathing easier or be given a blood transfusion to reduce exhaustion.

Palliative and Hospice Care

Despite its growing popularity in medical centers, most People in America remain unaware of the comfort and benefits palliative care can offer some critically ill patients. “There is a clear need to notify customers about palliative care and offer customers with a definition of palliative care,” scientists requested by the Center to Advance Palliative Care advise. According to Public Opinion Research on Palliative Care, 70 % of the general population doesn’t know anything about palliative care, and 14 % were “somewhat knowledgeable.” The scientists also found that it is difficult to notify doctors about palliative care, because they often wrongly associate it with hospice care or end of life care.

hospice_carePalliative care is becoming increasingly extensive. There are more than 1,600 medical centers that have palliative care programs in the U.S., according to Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai School of Medicine. Some 85 % of large medical centers have a palliative care team. 67% of small medical centers have programs.

Hospice care is different from palliative care; its aim is to handle signs so that an individual’s last times are invested with pride and quality. The care is not designed to cure the illness but the person, according to the American Cancer Society. Hospice is most often used when healing therapy is no longer effective, and a terminal individual is predicted to live about six months or less. “Many individuals believe that hospice is only for individuals who have cancer. This may be due to the fact that many of the sufferers treated in the beginning of hospice were cancer sufferers,” Becky Hillier, advertising director for Rocky Mountain Hospice, had written for the Montana Standard. Less than 25 % of hospice sufferers admitted to the hospice are cancer sufferers.