Hospice is a philosophy of care that accepts dying as the final stage of life, according to the American Cancer Society. The term was first applied in 1967 to the specialized care provided to terminally ill patients and their families. Although most hospice care in the United States is provided in the home, it is also available to residents of long-term care facilities, as well as to hospitalized patients.
Services
Hospice care seeks to provide the best quality of life for dying patients by tending to their physical, spiritual, mental and emotional needs, as well as the needs of their families. Hospice services, according to the American Cancer Society, include control of pain and other symptoms, allowing the patient to live as fully as possible at the end of life. Spiritual care, education, help with end-of-life arrangements and counseling are also vital aspects of hospice care. In long-term-care settings, anyone who has formed a close relationship with the patient, including staff members and other residents, is offered support, education and counseling, as well.
Eligibility
Eligibility for hospice services requires a referral from a physician who certifies that the patient's life expectancy is six months or less if the disease runs its expected course. The patient must also agree to receive hospice services and is free to withdraw at any time. If the patient is not mentally competent, the person he has designated to make medical decisions for him may consent. Hospice services can continue beyond six months, if needed.
Settings
More than 90 percent of hospice services in the United States are provided in the home of the patient or a relative, but long-term-care residents who become terminally ill can also access hospice services. Some long-term-care facilities transfer eligible residents to their own hospice units, but many contract with community-based hospices or home-health agencies to provide care within the facility. Hospitalized patients can also access hospice services.
Providers
Hospice teams are composed of specially trained nurses, doctors, social workers, spiritual-care providers, aides, bereavement counselors and volunteers. The team coordinates the patient's care, makes regular visits and is on call 24 hours a day.
Financial Issues
Payment for end-of-life care depends on the setting, as well as the patient's resources. Medicare, Medicaid, private medical insurance, long-term-care insurance, personal resources, donations and Department of Veterans' Affairs benefits are common payment sources, according to the National Institute of Aging. Most states also provide Medicaid hospice benefits for those who qualify.
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