People facing a fatal illness may find their situation made worse by their lack of control and the “poking and prodding” of treatment and testing despite certain knowledge of their advancing fate. The National Hospice and Palliative Care Organization statistics show that approximately 1.6 million people in the United States ease their end-of-life transition through the use of hospice care.

“Hospice is care for the terminally ill. Hospice care focuses on symptom management and allowing the individual to enjoy their final days as fully as possible,” Jennifer Hesser, director of Willis- Knighton Hospice of Louisiana, part of the Willis-Knighton Health System, said. “Most insurance including Medicare and Medicaid cover hospice 100 percent with no out-of-pocket costs for palliative treatment related to patient’s terminal illness.

“Palliative, in this case, means treatment of symptoms and not cure-directed treatment. When a patient becomes eligible for hospice care, the days of their life are limited. However, our goal is to add life to their days. Hospice employs an interdisciplinary approach to caring for patients. In addition to medical symptom management by a physician and care from a registered nurse, the patient also receives services from an aide, social worker and a chaplain. Additionally, we have a bereavement program that cares for the patient and family as well as a volunteer program which assists us in providing companionship and other needed services to the patient. Hospice is not only for the patient, but we also are able to assist family members/loved ones with dealing with the transitions of end of life.”

The Mayo Clinic gives the rule of thumb for hospice care as being generally recommended for those who are expected to have six months or less to live. That doesn’t mean that hospice care will be provided for only six months; the care may continue being provided for quite some time so long as the attending doctor and hospice care team certify that the condition remains life-limiting. While many patients seem to think that hospice means “dying in a hospital,” the Mayo Clinic provides the statistic that approximately 80 percent of hospice care is given at home with a family member as the primary caregiver and hospice staff providing support functions, respite care, and are ready with counseling, advice and medical supervision. When hospice does take place in an professionalcare environment, efforts are made to make patients as comfortable and at home as possible.

“The caring people who work in hospice become experts in end-of-life management,” Hesser said. “From early recognition of symptoms that indicate decline, to providing a listening ear for an overwhelmed caregiver, to provision of educational materials and emotional support to the family during the final days – these are the areas where hospice workers shine. Very often families report the support they received from hospice is what equipped them to take care of their loved one while they enjoyed their final days at home. Taking care of a loved one during their final days can be a lonely and overwhelming task. We are able to reduce that feeling of being alone as well as providing education and support that equips the family for their difficult task.

“Each hospice has a bereavement program, which continues to provide support to the family for at least 12 months following the patient’s death. Support provided includes visits from a bereavement specialist in which family is encouraged to express their feelings about their loss, regular mailings of personalized letters and bereavement support material, an available bereavement support group and an annual memorial service in which all hospice patients from the prior year are honored.

“Hospice admission begins with a physician order/referral and a certification from the physician that the patient has a terminal illness,” Hesser said. “Following this, a representative from hospice will make contact with the patient and/or family and determine what their goals/ needs/expectations of hospice will be. The admission visit is completed by a registered nurse and can be rather lengthy. We do a very detailed assessment which explores physical, psychosocial and spiritual needs. From this data, an individualized plan of care is established, which allows us to care for each patient according to their specific needs and wishes. Often medical equipment and medications will also be delivered and instruction provided during the admission visit.

“Although each hospice has a medical director who assists in managing the patient’s care, the doctor who orders hospice may elect to continue as attending physician for the individual patient. An individual or family looking to choose a hospice should look for a hospice to be licensed by the state and must provide 24- hour call coverage to meet the needs of those they serve. The hospice staff should be experts in end-of-life management. They should be able to provide early recognition of symptoms, a listening ear, educational materials and emotional support.”