LEADS FORUM: Hospice is not about giving up

By SAMANTHA BECHTEL, Bereavement Coordinator, Stein Hospice Leadership Erie County Clas
Sandusky Register Staff
May 24, 2010


By SAMANTHA BECHTEL, Bereavement Coordinator, Stein Hospice

Leadership Erie County Class of 2009

Investigating hospice is something every terminally ill patient and their families should look into.

Patients and their families may feel hiring hospice is giving up and their hope for recovery will be eliminated. Before working in hospice, I may have believed the same thing because society still shies from discussions on death and dying although all of us will die.

Hospice is a special way of caring for a patient whose disease cannot be cured. Hospice care employs a family-centered approach, recognizing that caring for a dying person can be difficult, and extends care to a patient's loved ones as well.

The goal of this care is to help the patient live free from pain and suffering. Other goals include: helping patients be independent for as long as possible, receiving support through the stages of the dying process, receiving care for family and friends, and dying with dignity.

Hospice care is a team-oriented approach to provide expert medical, emotional and spiritual care. It is tailored to the patient's needs and wishes, as well as to needs of the patient's loved ones. This team may consist of doctors, nurses, social workers, home health aides, clergy, volunteers and bereavement counselors. Medicare, Medicaid and most private insurance plans include provisions for hospice care. Hospice is available 24 hours a day, 7 days a week. Hospice is a philosophy of care and can be delivered wherever the patient calls home. In most cases, care is provided in the patient's or a loved one's home. It is also provided in freestanding hospice centers, hospitals, long-term care facilities and assisted living.

Hospice patients are eligible for the hospice benefit when a doctor has certified they have a terminal diagnosis with an estimated prognosis of six months or less to live. However, it is recognized that terminal illness does not have an entirely predictable course and making medical prognoses of life expectancy is not always an exact science. Some common diagnoses may include but are not limited to: Alzheimer's, Parkinson's, liver disease, COPD/lung disease, renal failure, adult failure to thrive, end-stage diabetes, certain heart problems, and cancer.

Four different categories of hospice care are available. Routine home care is provided when the person is not in a medical crisis. Continuous care is around the clock care, when there is a medical crisis. General inpatient care, at an inpatient facility, is provided when care cannot be managed where the patient resides. Inpatient respite care is available to give the family caregiver a rest, for periods of up to 5 consecutive days.

Caring and compassionate hospice professionals are dedicated to helping their patients having a beautiful life and dignified death. Hospice families are relieved of the financial stress and have a team of hospice staff that help to meet their needs and journey with them during and after the process. Our economy benefits as well, since home hospice care saves health care benefit dollars. The federal government's studies conducted prior to 1983 demonstrated, on the average, hospice care saves between $1,500 and $3,000 per patient in health care expenses during the last 3 months of life. The rapid growth of hospital costs since 1989 have made the rate of cost savings even higher.

Hospice care can also decrease absentee related costs to employers of individuals who have to care for their loved ones. Through the support and services of the hospice team, family members are more likely to be able to work with fewer interruptions. Their focus and concentration at work can be of more quality than if hospice were not involved, because of the emotional and spiritual support and care received by hospice. Hospice can also benefit the health care providers. Some health care providers are not well trained to deal with terminal illness and death. Hospitals are designed primarily to cure patients, not to help them through the social and emotional aspects of dying. Hospices with accredited and certified hospice programs provide a resource to which health care providers can refer patients with confidence.

The community at large can also benefit from hospice. Many hospice organizations provide education and support to the public in general about dealing with death and dying, grief and loss.

By learning about hospice, I think more families should take notice of hospice services and realize that accepting hospice care is not an acceptance of a death sentence, but rather a way to live with less stress for the patient and themselves. The patients and families served by hospice will attest to this and it is to them I dedicate my thoughts.

Stein Hospice's motto says it best: "It is not about giving up, it is about living until you die".