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Hospice Care: What’s it all about? By Susan Burket, Communications Manager, Montgomery Hospice
9/23/2009

The term “hospice” refers to care provided to a seriously ill patient who has chosen to concentrate on quality of life rather than curative treatments. Hospice care is usually provided in a person’s home, which may be a nursing home, assisted living facility, or the home of a friend or family member. The cost of hospice care is covered by Medicare and most insurance companies. The coverage includes medical equipment and supplies, medications, and visits by the members of the hospice team. The “hospice team” consists of a medical director, a nurse, a nursing assistant, a chaplain, a social worker and trained volunteers. This team works together with the patient’s family and the patient’s personal doctor to manage physical pain and symptoms, and also work to resolve any emotional, spiritual or practical issues. Some hospice programs have an “inpatient” facility where they care for patients whose symptoms cannot be effectively managed in their homes.
Another important benefit that a hospice program offers is bereavement care, sometimes called grief care, which is provided in ways that fit each person's values, beliefs and culture. Hospice counselors work with the patient and their family during the illness and also provide support to family members for a year after the patient’s death.

Hospice care is designed to provide dignity and support to patients who are expected to have six months or less to live. If their condition improves, they can be ‘discharged’ from hospice. Others continue in hospice care for longer than six months. Patients can choose to leave hospice at any time if, for example, they decide to pursue more aggressive treatments.

The decision to use hospice can be a difficult one to make. Putting off the decision, however, means that the patient and family don’t receive the many benefits that hospice care offers. Families should educate themselves on all options, including hospice, and discuss these choices with their doctor.

Montgomery Hospice has been serving the Montgomery County for 29 years. In 2008 we helped more than 1400 patients and supported more than 5600 county residents with bereavement services provided by professional counselors. Our acute-care facility, Casey House, is the only facility in the county devoted to hospice patients. Our staff is available to patients and their families day and night, seven days a week. Montgomery Hospice professionals (www.montgomeryhospice.org ; 301-921-4400) would welcome the opportunity to discuss a family’s particular circumstances and provide information and guidance.

More general information about hospice can be found by contacting the Hospice Foundation of American (www.hospicefoundation.org; 800.854.3402) or the National Hospice and Palliative Care Organization (www.nhpco.org; 703.837.1500).  When choosing a hospice program, it can be helpful to look for programs that are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or by the Community Health Accreditation Program (CHAP). Also, any hospice that is Medicare certified follows strict procedures for patient care.


“I want to write you this to personally thank you and your team of professionals for the excellent care my mother received from Montgomery Hospice during the last months of her life.

My family and I appreciated that you were able to make my mother feel that she was in charge of her life and her health care decisions in spite of the fact that her mental and physical capacities were declining.

You were able to update us and her physicians on her actual condition, answer our questions honestly and make informed suggestions based on your experience (to us and to mother) on how to deal with her changing situation.

Throughout the whole time, my mother was able to retain her dignity and respect. I highly recommend your services to any family who wants to ensure their loved one receives the best of care from knowledgeable and caring professionals such as those employed by Montgomery Hospice. I know we all appreciated the peace of mind you provided at a time when we needed it! Thank you!”

Who:

People with serious illness who need care that will support their quality of life.
Hospice medical staff members who are experts in aggressive pain and symptom management. Other hospice professionals who provide spiritual and bereavement care.
The patient’s personal physician working in collaboration with the hospice professionals.
Other support for the family, including home health providers such as Right At Home a leading home care agency with offices in Bowie and Rockville, Maryland.

What:

Comfort care, support for entire family.
Using time to make memories, spending time with loved ones.

Where:

Hospice patients usually stay in their own homes. Hospice care is provided to people who live in extended care facilities, such as assisted living centers or nursing homes.

When:

Hospice is appropriate when the prognosis is six months or less, and when treatment options for cure are no longer available or are limited.
How costs are paid:
Medicare, Medicaid and many other insurance plans. Nonprofit hospices often provide care for people without insurance.

Why hospice:

The caring professionals at hospice provide expert end-of-life support, are available to answer questions at any time (including the middle of the night) and can help minimize trips to the emergency room.

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