Hospice Facts, Myths, and Realities
Being on Hospice means that the individual will soon die.
Reality: People choose Hospice when they have a life limiting illness and no longer desire aggressive medical intervention or have been told by their medical provider they will no longer benefit from aggressive medical intervention. Hospice care focuses on comfort, pain and symptom management, and quality of life for individuals with a life limiting illness. Good hospice care does not shorten the individual’s life and may even result in a longer length of survival.
Hospice means giving up hope.
Reality: Hospice helps individuals and their families focus on reclaiming and maintaining their quality and spirit of life and guides them in finding acceptance, healing, and peace during the dying process.
Hospice is a place.
Reality: Hospice is a model and philosophy of care that focuses on alleviating the individual’s pain and discomfort and as well as attending to the emotional, spiritual, and social needs of the individual and family. Hospice care is provided in the comfort the individual’s home or residence, including a nursing home, assisted living facility, or residential care setting.
A physician decides whether a patient should receive hospice care and which agency should provide that care.
Reality: Anyone can ask about their physician about the benefits and appropriateness of hospice care. In order to receive hospice care, a physician must certify that the individual has a life limiting or terminal illness and an estimated life expectancy of six months or less if the illness runs its usual course of progression. Together, the patient, family, and physician determine when hospice services should begin. It is up to the individual/family to determine which hospice they would like to receive care from.
Hospice is only for cancer patients.
Reality: More than half of the hospice patients nationwide are diagnosed with other medical illnesses or advanced stages of chronic diseases like pulmonary disease, Alzheimer’s disease, renal disease, HIV/AIDS and cardiovascular or neuromuscular diseases.
Patients can only receive hospice care for up to 6 months.
Reality: The Medicare hospice benefit and most private insurance companies pay for hospice care as long as the patient meets the established criteria. Hospice is required to conduct a re-certification evaluation for each patient on a regular basis to determine if the patient continues to meet eligibility criteria. He/she can continue receiving hospice care as long as the attending physician recertifies that the patient is terminally ill.
Hospice provides 24-hour care.
Reality: The hospice benefit does not cover in home or personal care, however, the hospice social worker will assist with obtaining these services through an agency that does provide in home care. The hospice team (nurses, social workers, home health aides, volunteers, chaplains, and bereavement counselors) does conduct weekly routine and as needed visits and is available 24 hours a day; 7 days a week; 365 days a year.
To be eligible for hospice care a patient must already be bedridden.
Reality: Hospice care is appropriate at the time of the terminal prognosis, regardless of the individual’s physical condition. Many hospice patients continue to lead productive and rewarding lives.
Once a patient elects hospice he or she can no longer receive care from the primary care physician.
Reality: Hospice reinforces the patient-primary physician relationship by advocating either office or home visits, according to the physician preference. Hospices work closely with the primary physician and consider the continuation of the patient-physician relationship to be of the highest priority.
To be on hospice a patient must have sign a Do Not Resuscitate (DNR) order.
Reality: A patient can receive hospice care and without signing a DNR Directive. Hospice regulations prevent hospice from discriminating against individuals due to advance directive choices.
In 2013 more than 44 percent of Americans with less than six months to live chose hospice care and 97 percent of those people choose home hospice care.
80 percent of individuals with a life limiting terminal illness indicated they would prefer to die at home.
Hospice enrollment is not significantly associated with shorter survival times and may even result in a longer length of survival.
NCHPO | NCBI Report | NCBI Report
Hospice care resulted in fewer hospital readmissions, emergency room visits and unnecessary treatments. and improved patient and family satisfaction.
NCBI Report | Jama Network
Even with the many positive outcomes associated with hospice care 35% of hospice referrals still occur in the last week of life… This late intervention does not allow enough time for the full benefits of hospice care to be experienced by the patient or the family.
NHPCO Report | Health IT Outcomes