What is Hospice Care, When Should It Start and What are the Goals of Hospice Care?

What is Hospice Care?

Hospice care is a team of people who provide care for those who have a life-limiting illness.

Hospice care is mostly associated with people with cancer who no longer wish to receive treatment but is for anyone who has 6 months or fewer to live.(1)

In hospice care, the patient no longer receives a treatment to cure the condition or extend life, instead, is given the care to relieve pain and make the remaining life more comfortable.

Hospice care intends to provide emotional, spiritual, and psychosocial help and support to the patient and the family.

There are four levels of hospice care:

  1. Routine Home Care: It is a standard level of care in which the hospice team comes to the home of the patient and provides nursing, therapeutic, spiritual, and other care.
  2. Continuous Home Care: Patients with a medical emergency need around-the-clock care. In this case, continuous home care is provided by the team.
  3. General Inpatient Care: It is difficult to take care of some patients at home. Here comes the role of inpatient hospice stay. The symptoms can be addressed at the inpatient care and then he can return to routine hospice care at home.
  4. Respite Care: It is a facility in which the patient stays in inpatient hospice stay, with a skilled nurse to take care for a set period. This can help the family members to take a break from full-time caregiving.

The level of hospice care does not affect the quality of care. Even though the settings change the plan of care does not.

When Should Hospice Care Start?

Hospice care begins when the illness has advanced to a stage where it is no longer curable and there is no way it can be controlled.

A qualified hospice doctor and the patient’s doctor decide whether the patient meets the criteria of hospice care.

The patient for hospice care should meet the following criteria:

  • Has fewer months i.e. less than 6 months to live
  • Not improving after treatment
  • Quality of life is declining
  • Decides to stop the treatment to prolong the life

The patient might live longer than 6 months, be able to continue to receive hospice care if the doctor recertifies.

According to the American Cancer Society, it rarely happens that people receive hospice care early enough.(2)

A study was done on people who receive hospice care too late found that there were patient dissatisfaction and unmet needs in 10%.(3) Those with shorter stays in hospice have family members with a higher level of dissatisfaction with care.

What is the Goal of Hospice Care?

The target of hospice care is to give the possible quality of life to the patient diagnosed with a terminal illness.

It does not perform any tests or procedures, instead, provides relief from pain and symptoms and emotional and spiritual support.

As a patient enters hospice care, he is asked to appoint a primary caregiver, who can be a family member or a close friend. This person coordinates with the care team and develops a customized plan.

The care team includes doctors, nurses, nurse assistants, physical therapists, occupational therapists, dieticians, social workers, and speech therapists.

A study done on people with dementia found, families of those receiving hospice care, were more satisfied with the quality of care.(4)

The services a patient receives depend on the condition of the patient and it can include:

  • Pain relief medications
  • Medication for symptom management
  • Mobility aids such as wheelchairs and walkers
  • Medical supply for home care
  • Nutrition service and meal planning
  • Grief counseling and emotional support to the family
  • Physical, occupational, and speech therapist
  • Assistance for daily activities.

A hospice care plan is built around the patient and his care. The patient stays where he is receiving hospice care. The care team members come as needed. They are available 24/7.

Hospice vs. Palliative Care

There might be some overlap between hospice care and palliative care, but both of them are different.

A survey found many people had misperceptions about both.(5)

Both types of care manage symptoms and address the psychosocial needs of the patient and improve the quality of life.

Palliative care goes side by side with curative treatment, which is not the case with hospice care.

Hospice care takes place when someone with a serious illness nears the end of life. It is designed to ease the symptoms and minimize any complications.

Palliative care is separate from the medical team that provides treatment for the illness. Hospice care teams comprise the majority of a person’s care.

Hospice care is for people who are at their end stages of illness. It eases pain and other discomforting symptoms. The motive is to help people live their final days comfortably.

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