LEXINGTON As someone who spends a significant amount of time discussing end-of-life care in professional and community settings I am familiar with the more pervasive misconceptions about hospice care and the discomfort that comes with discussing advance care planning, serious illness, the dying process, and death. Because of this, it is important to provide clarity on the programs and services offered by hospice providers, the value of hospice care for patients and families, and the importance of advance care planning.
Hospice services are available to individuals with serious illness, typically in the last six months of life, who have elected treatments aimed at palliating the symptoms of their disease irrespective of age or diagnosis. These services include an interdisciplinary team of highly trained professionals who work with a patient and family to identify their goals of care and then design treatments, therapies, and interventions to maximize the patient’s quality of life. This team includes hospice physicians specially trained in managing sources of intractable pain and other symptoms causing distress or discomfort; nurses who make home visits to ensure the patient is comfortable and to teach both the patient and caregiver about the disease progression to increase caregiver confidence; certified nursing assistants who assist with bathing, dressing, and other activities of daily living; social workers who provide counseling services to the patient and family and connect them to available resources in their area; chaplains who respond to the spiritual needs of the patient and caregiver; and volunteers who offer practical support to the patient and family such as transportation, companionship, and respite care for the caregiver. Hospice care also includes individual and group counseling services available to the family after a patient dies. In addition to the interdisciplinary team, hospice services also include providing all the medications, medical supplies, and equipment related to the terminal diagnosis. Succinctly, hospice providers are experts at providing quality physical, psychosocial, and spiritual care to individuals in the late stage of serious illness while also supporting their families.
There is an abundance of evidence that demonstrates that quality of life increases for the patient and family and patient preferences for treatment are followed more often when hospice becomes involved. Patients are able to spend their final months surrounded by loved ones with their symptoms managed effectively and improved quality of life rather than spending that time in emergency departments, hospitals, and intensive care units. It is for these reasons that a recurring comment from patients and families is, “I wish I had known about hospice care sooner.”
Despite the overwhelming evidence on the value of hospice and that hospice is a benefit for individuals in the last six months of life, nationally the average length of stay from admission to death is 67 days, and the median length of stay is 17 days. More troubling is that, one-third of patients admitted to a hospice program die within a week of admission. These short lengths of stay are problematic for myriad reasons but primarily because the patient and family are not able to take full advantage of the scope of hospice services.
Hospice of the Bluegrass is committed to ensuring that all individuals know about the availability and value of hospice services. For healthcare providers, we offer education on having difficult conversations with patients facing serious illness and on how hospice and palliative care can help your patients. For individuals in our community, we offer training on a wide range of topics related to end-of-life care including but not limited to advance care planning, understanding hospice and palliative services, and grief and loss.
With an aging population the need for advance care planning and the broader utilization of hospice and palliative care is essential. Hospice of the Bluegrass is here to meet the needs of the seriously ill and their families in our communities.
THERE IS AN ABUNDANCE OF EVIDENCE THAT DEMONSTRATES THAT QUALITY OF LIFE INCREASES FOR THE PATIENT AND FAMILY AND PATIENT PREFERENCES FOR TREATMENT ARE FOLLOWED MORE OFTEN WHEN HOSPICE BECOMES INVOLVED.
Turner West, MPH, MTS is director of Education and Community Programs at Hospice of the Bluegrass.