Hospice Care (Q&A)

What is hospice care?
Hospice care refers to care given to a patient when medical treatment cannot offer a cure nor can it prevent further deterioration of the patient’s disease. The life expectancy of the patient may be less than six months. Under these circumstances, hospice care is given to alleviate the symptoms for the patient, and provide emotional support, spiritual and social care for both the patient and his/her family in order to improve their quality of life. Hospice Care neither hastens nor postpones death, but assists and supports the patient and family till the natural end of life. Hospice care has been practiced in the US for more than forty years and many ethnic groups have benefited from this. However, many Asians and Chinese are still quite unfamiliar with the concepts of hospice care and the resources which it offers, due to the cultural tendency to avoid the subject of death.

What are the key concepts of hospice care?
When we recognize that there is limited time left in a life, we can cease to struggle to expend all our efforts to fill those precious moments. This frees us to treasure the time and strength we have in peaceful and enjoyable moments with our families. We can use the time to express our appreciation, thankfulness, and care for each other. We can apologize to our loved ones, tell them we love them and say our good byes. Hospice care is care for life, not death. It understands emotional pain and provides support. It helps to lessen and control physical pain, so that the patient can spend time with his/her family and loved ones. In the process, the spiritual needs of the patient can also be addressed. The patient can clarify and affirm his personal meaning in life, so as to fulfill and complete his relationship with himself, others and with God.

What is the difference between hospice care and euthanasia?
Hospice care and euthanasia represent two entirely different perspectives and ways for managing end of life. Euthanasia refers to the belief that, when faced with extreme physical or emotional pain, a person can have his/her own right to commit suicide or use medical assistance to end life before its natural end. Hospice care does not endorse euthanasia.

What are some practical measures used in hospice care?
Hospice care includes:
Care for the whole person: Hospice care provides holistic care - care for the physical, emotional and spiritual needs of the patient. Physical care includes control of symptoms and treatment for pain. Emotional care includes emotional support, counseling, and explanation of resources available in the community. Spiritual care includes guidance in beliefs, clarification of the meaning of life and restoration of relationships.
Care by an entire team: Hospice care is provided by a team of professionals which include physicians, registered nurses, home health aides, social workers, chaplains, trained volunteers and other professionals such as nutritionists.
Care for the entire process: Hospice care is provided to the patient from the day he/she is entered into the program to the end of life, after funeral services. Key medical personnel is on call 24 hours a day every day. After the passing of the patient, the team provides bereavement counseling to family members for one year.
Care for the entire family: Care is provided to family members including the spouse, children, parents, other relatives and key friends.

What are the conditions for enrolling in hospice care?
When the primary physician tells the patient that disease-targeted therapy (such as chemotherapy for cancer) can no longer control the deterioration of the disease, and that the life expectancy would be less than 6 months, then the patient has the right to terminate treatment and be enrolled in hospice care. Hospice care can start on that very day. If the patient’s condition improves, hospice provider will stop providing services and the patient can decide at any time to cease hospice care and be treated again. Hospice care is not only for cancer patients. It can be applied to all terminally ill patients, in cases such as dementia, heart, lung or kidney diseases, etc.

How are fees for hospice care paid?
Hospice care is eligible for Medicare or Medi-Cal full reimbursement. It is also fully reimbursed by private insurances. If the patient does not have health insurance, then he/she can seek hospices run by non-profit charity organizations.

What services are provided by hospice care?
Hospice care provides medicines for symptomatic relief and treatment for pain. The hospice team provides home visits and medical equipment for the home. It also provides bereavement counseling for family members for one year after the passing of the patient.

Where can hospice care be provided?
Hospice care can be provided in the patient’s home, retirement community, or elder nursing facilities.