‘Hospice’ is a term that describes a specific type of symptom management care for people who will eventually die as a result of a progressive disease. In order to make informed decisions and take advantage of the personalized level of care and services that hospice offers, we can correct our misconceptions.
Myth: People cannot be referred to hospice until death is imminent.Correction: While it is true that some hospice referrals are made “after all else has failed”, it is also true that consumers are demanding more choice and control regarding their health care. In response to wishes for comfort, dignity, and quality of life, a new trend toward earlier hospice access is emerging.
Myth: Hospice means “giving up”.Correction: Hospice means changing focus. The focus of hospice care is on aggressive management of the patient and family’s experience of the illness, as distinct from an aggressive focus on treatment to cure the illness itself. Hospice care is dedicated to enhancing and maintaining comfort, dignity, and quality of life as defined by a patient and his or her family. In fact, if a palliative approach to illness meets their goals, asking for and receiving hospice care “after all else has failed” is often the greatest regret patients and their families have.
Myth: Hospice care takes place in a hospice facility where the patient must move in order to become a hospice patient.Correction: While a small percentage of hospice care occurs in hospice facilities, the vast majority (over 90%) of hospice care occurs in patients’ homes (including nursing homes). We realize that most people prefer to live their remaining days at home; it is not necessary to relocate to a hospice facility to become a hospice patient.
Myth: Hospice patients receive large quantities of narcotic medication to control their pain. That makes them drowsy or unresponsive and sometimes leads to addiction.Correction: Hospice professionals are experts in comfort care. Many different methods of pain and symptom control, including relaxation techniques and massage are available today. In the event that medication is a preferred treatment, there has been no evidence supporting the idea that prolonged drowsiness occurs when narcotic medication is used to control real physical pain. In fact, as long as real physical pain is present, addiction is never an issue.
Myth: Once a person enrolls in a hospice program they decline very quickly.Correction: Rapid decline is always possible when a serious illness is present. It is more common, however, for hospice patients to rally in response to the personalized care for mind, body, and spirit they receive. The goal of hospice is to provide care for all the problems that interfere with the quality of life.
Myth: Patients can only receive hospice benefits for six months or less.Correction: There is, indeed, language in Medicare, Medicaid, and most private insurance policies speaking to a requirement for the life expectancy of six months or less. There is recognition, however, that every person progresses through the stages of illness differently; thus, it is exceptionally uncommon for a policy to limit the number of days or months for hospice care. The stability of the disease process is never a cause for discharge. If the underlying terminal disease process continues to be present and the patient and family continue to desire a palliative approach to treatment, they can keep their hospice benefit for as long as they need it. Hospices are not required to discharge a patient because of failure to die.
Myth: Once somebody chooses hospice care they can never change their minds.Correction: Freedom of choice is always a right of patients and families. At each point of symptom change along the way, hospices should encourage patients and families to continually assess their goals and options.