Quality end-of-life care isn't about how you die; it's about how you live. Hospice and palliative care focuses on how dying persons and their loved ones live each day, providing comfort and guidance along the way.
While the number of people choosing hospice care at the end of life continues to grow, many myths exist about hospice that deter people from seeking out this compassionate system of care.
1. Choosing hospice means that I'm "giving up."
When cure is no longer possible, hospice provides the type of care most people say they want at the end of life--comfort and quality of life. The most common statement made by families who chose hospice for their loved one is, "we wish we had known about hospice sooner."
2. Hospice care won't allow me or my family to be involved in making decisions about treatment.
Hospice puts patients and families at the center of care. Trained professionals provide guidance and encourage open, honest communication about individual wishes and choices.
3. My grandmother died in a great deal of pain, but that's just to be expected as part of the dying process.
Hospice doctors, nurses, and others are specially trained to control each person's pain, while still keeping the patient awake and alert whenever possible.
4. I want to care for my husband at home; I don't want him to go to a hospice.
Hospice is not a place but a philosophy of care. The majority of hospice care takes place in the home, where the person can be surrounded by family and familiar settings.
5. My mother lives in a nursing home and I can't bring her to my home to care for her, so hospice wouldn't be available.
Hospice and palliative care is available in nursing homes, assisted living facilities, and even hospitals--wherever the patient lives and considers home.
6. Hospice care just keeps dying people heavily medicated; all they focus on is the physical process of dying.
Hospice pain management is highly specialized and tailored to each individual, to ensure the highest quality of life possible to live each day until the end. Arbor Hospice clinicians are specially-trained to manage pain and symptoms at the end of life so patients are comfortable, yet alert and able to enjoy each day to the fullest extent possible. In addition, hospice utilizes complementary therapies such as music and art, and provides emotional and spiritual support to the dying person and the loved ones, including bereavement support for the family after the death.
7. My partner's doctor suggested hospice; that must mean that my partner has only a few days left to live.
Hospice care is available to anyone who has a life-threatening or terminal illness, that has a prognosis of six months or less if the illness runs its normal course. Care from Arbor Hospice is most beneficial when there is sufficient time to manage symptoms and establish a trusting relationship. Patients can remain in hospice longer than six months if necessary.
8. My son is dying of AIDS, and I want the most compassionate care possible for him. But someone told me hospice care is only for older people with cancer.
Anyone with a terminal illness who meets hospice eligibility requirements may choose to receive care from Arbor Hospice. More than 50 percent of hospice patients nationwide have a diagnosis other than cancer. Increasingly, Arbor Hospice is serving families coping with end-stages of chronic diseases like emphysema, COPD, Alzheimer's cardiovascular and neuromuscular diseases.
9. My grandfather doesn't have private insurance, so he won't be able to afford good end-of-life care when he needs it.
Hospice is fully covered by Medicare, by Medicaid, and by most HMOs and insurance companies.
10. We live in a rural area, so there won't be any hospice programs that can help me care for my daughter.
More than 4,100 hospice programs serve all regions of the US; less than one percent of Medicare beneficiaries live in an area where hospice in not available.
11. When someone is on hospice, all medications will be stopped.
The Medicare Hospice Benefit covers the cost of hospice services, medications and equipment related to the terminal illness. Patients can continue to take medications to manage conditions other than their terminal illnes if they wish to do so, but they will not be covered under the hospice benefit.
12. Good care at the end of life is very expensive.
Care from Arbor Hospice is covered by Medicare, Medicaid and most private insurances. Through generous community support, The Arbor Hospice Foundation ensures no one is turned away because they do not have insurance.
13. Hospice administers morphine to hasten the dying process.
The hospice philosophy of care is built on a commitment of allowing death to happen on its own time. Arbor Hospice does not support the administration of any drug to hasten death or prevent it from happening.
14. When someone signs onto hospice, they can never get out.
Patients may sign on or off hospice as many times as they wish. Nationally, 20 percent of patients discharge from hospice. At anytime, if a patient wishes to pursue curative treatments, he/she may sign off hospice. In addition, some hospice patients are discharged because they no longer meet hospice eligibility guidelines.
15. In order to receive hospice services, I must sign a Do Not Resuscitate Order.
Arbor Hospice allows patients to make their own choice about whether they prefer to be resuscitated or die naturally in the event their heart or breathing stops. We do not require patients to have a do-not-resuscitate (DNR) status. At the time of admission, Arbor Hospice will talk with the patient and/or family to be certain of their end-of-life wishes and advance directives are reflected in the patient's plan of care.
16. All hospice programs are the same, it doesn't matter which one I call.
All licensed hospice programs must provide certain services, but the range of support services and programs may differ. Like other medical care providers, business models differ. Some programs are not-for-profit and their revenue is used to provide patient care and community services, versus for-profit hospices, which are accountable to shareholders. Arbor Hospice is a non-profit hospice dedicated to its mission to provide the highest quality care, assurance and education for patients and families.
17. Arbor Hospice patients cannot receive treatments such as chemotherapy, radiation therapy and blood transfusions.
Each patient's plan of care is different. Arbor Hospice reviews each patient to determine if a specific treatment is important for pain or symptom relief. Arbor Hospice may accept a patient receiving one of these palliative treatments if those treatments are providing comfort for patients, the patient's life expectancy remains six months or less and the goal of care is no longer curative.
18. My dad signed on to hospice and died two days later. Hospice hastens death.
Hospice does not to hasten or prolong life. Nationally and locally, hospices have a short length of stay. Many individuals are referred to hospice closer to the end of life and as a result, the myth is often accurate. The Medicare Hospice Benefit is a six month benefit. Care from Arbor Hospice is most beneficial when there is sufficient time to manage symptoms and establish a trusting relationship.
This information in provided by the National Hospice and Palliative Care Organization and Arbor Hospice