Considering Hospice Care
The last stages of a serious illness can be so hard. You may feel like you have lost control over your life and what will happen to you.
Hospice can help you get back some control by showing you what your options are and helping you make decisions about things that are important to you.
You may want to consider hospice care if:
- You have a disease or illness that is expected to shorten your life.
- Treatment that tries to cure the disease or prolong your life has become more of a burden than a benefit to you.
- You would like to spend your remaining life as comfortably as possible in a setting that you choose, such as your own home.
- You want family and friends to participate in your care.
- You want your loved one who has a serious illness to die comfortably at home.
Some people who might benefit from hospice care don't receive it. Many people, including some health professionals, simply don't know much about it. It can be hard for a doctor to talk to a patient about hospice, because it means talking about the end of life.
It can also be hard for you and your family to accept that the end of life is near. Some families choose to pursue aggressive medical care up to the end.
Who is eligible
Eligibility for most hospice programs is usually based on two main requirements:
- Your illness can't be cured. This is called a terminal illness.
- Your doctor expects that you will live 6 months or less if your illness runs its normal course. Typically a form must be signed by your primary doctor as well as the medical director or physician member of a hospice team.
It can be hard for doctors to know how long a person will live. Some people live longer than expected. If you do live longer than 6 months, you can continue with hospice. If your illness gets better, you can stop receiving hospice care. You may no longer qualify for it.
Hospice care is generally paid for by Medicare, Medicaid, and private insurance. Care may also be available to those unable to pay.
Hospice care for special situations
Some people are living with a terminal illness that is not predictable. They may not necessarily die within 6 months. In fact, they may live for several years. But they may still be eligible for hospice care.
There are guidelines for terminal diseases that have an unpredictable course. People who have the following illnesses may have hospice care when their disease has reached an advanced stage:
- Heart failure.
- Kidney disease.
- Alzheimer's disease.
Many people who are living with a disease that has an unpredictable but still terminal course may also want and be able to receive hospice care. In some of these cases, Medicare might not cover hospice care costs. Medicare covers the cost of hospice in the last 6 months of life.
How to talk to your family and medical team
If you feel that you need to ask questions and explore your options about end-of-life care, including hospice, don't wait for your doctor or loved ones to bring up the subject. Be open and direct with your loved ones and your health professionals.
Your doctor can go over hospice care and other options with you. He or she can explain the pros and cons of each of them, answer questions, and advise you. Then you can think about the kinds of treatments you would or would not want in different situations. This can help you get a clear idea of your wishes.
You can make many choices about your end-of-life care ahead of time. Making plans while you are still able may ease your mind and make your final days more peaceful.
Write down any questions you have about hospice care to discuss with your doctor during your next visit. Let your family and doctor know what you decide so they can help carry out your wishes.
The goals of hospice
One goal of hospice is to allow you to live out your life without further treatment for your illness, as naturally as possible. You'll get medical care to provide comfort rather than to prolong life.
For example, chemotherapy may no longer be used to cure your cancer, but it may be given to reduce pain.
People who want to live as long as possible by any medical means are not a good match for hospice care.
Another goal of hospice is to give you as much control and dignity as possible during the time you have left. For example, most people in hospice can choose to die at home, surrounded by loved ones, rather than in a hospital, hooked up to one or more machines.
Other medical care is always available
It's important to understand that hospice doesn't include treatment to cure your illness. But your hospice team will prepare your caregivers to cope with almost anything that could happen at home.
And being in hospice care doesn't mean that you can't go to a hospital if you need to. When a hospice takes over your care, they will work with you to arrange for any medical care that you need. If something happens that causes a caregiver to call 911 , you may be treated in a hospital and later return to hospice care.
|By:||Reference Healthwise Staff||Last Revised: Reference August 14, 2012|
|Medical Review:||Reference E. Gregory Thompson, MD - Internal Medicine
Reference Kathleen Romito, MD - Family Medicine