What is Hospice Care?

Hospice CareHospice care was created less than forty years ago. Florence Wald, who recently died on November 15, 2008, is considered to be a leader in U.S. hospice care. She helped to organize the first program, Connecticut Hospice in Branford in 1974, and her husband and children also became involved in the hospice movement.

Wald’s work included efforts to bring hospice care to U.S. prisons and she trained inmates as hospice volunteers. The hospice movement, which focuses on providing care for terminally ill patients and their families, now includes more than 3,200 programs nationwide.

Mrs. Wald was a Dean at Yale Nursing School when, in 1963, a friend persuaded her to attend a lecture by Dame Cicely Saunders, a British physician who planned to open the world’s first hospice in Sydenham, south of London. Saunders’ hospice, St. Christopher’s Hospice, opened in 1967, and Mrs. Wald went there to work and learn. After returning, she and several Yale colleagues joined forces to establish the Connecticut hospice.

Wald’s hospice work was based upon the fact that terminally ill patients during that time period were subject to a medical ethic that ignored a patient’s transition from life to death, and her work gained national attention. Hospice care took a substantial leap in credibility when Congress ordered Medicare to begin to pay for the service in 1982.

Philosophy: The cornerstone to hospice care is Elizabeth Kubler Ross’ philosophy about death and dying, grief and grieving. After years of listening to and talking with dying patients, the lessons that evolved shaped today’s treatment for terminally ill patients and for their families.

Treatment: Usually, hospice patients have less than six months to live according to a physician’s diagnosis. These patients have chosen to stop curative treatment and to allow family members to learn how to provide care. Finally, most hospice patients prefer to die in their homes, surrounded by familiarity rather than in a clinical setting.

Financial issues: Although Medicare can pay for hospice care, many people who aren’t listed with Medicare may not be able to pay. And, many hospice organizations are beginning to face losses, as a federal regulation cut Medicare reimbursement rates to hospice programs after October 1, 2008. While many programs do not want to cut services, they may be forced to reduce staff and abilities to serve the dying through this rate cut. State funding, also, may be limited depending upon state financial issues.

Find a hospice: The National Hospice and Palliative Care Organization (NHPCO) can help you or a family member find a hospice near you. Established in 1992, NHPCO is committed to leading global, philanthropic efforts advancing quality, compassionate, end-of-life care for all. Their vision is “a world where individuals and families facing serious illness, death and grief will experience the best that humankind can offer.” Use their form to find a member organization near you, so you and your family members can benefit from their programs.

NHPCO is one organization that can help many people end their lives in dignity, surrounded by loved ones and with special care provided by hospice workers. If the government cannot support hospice care financially, the help needs to come from individuals, people who care about how the transition from life to death is conducted.

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