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Hospice care: support for the dying and for the people who love them

In western cultures, and particularly in the United States, our tendency has been to think of death in dark terms: fearful, unknown, painful. Today, however, more and more people are seeing death, like birth, as a natural part of life – if birth is the dawn of life, death is the sunset. The growth of the hospice movement and the wide availability of hospice care are largely responsible for this shift in attitude, providing a peaceful and comfortable transition for people reaching the end of their life.

In the weeks and months following the diagnosis of a serious illness, patients and their families typically work with their medical providers to pursue every avenue for recovery. In the best scenarios, medical or surgical treatments can eradicate the problem. In cases where no cure is available, the wonders of technology and modern medicine may offer patients an acceptable quality of life for a prolonged period of time.

Eventually, however, when all hope for a cure is exhausted, the time will come when the patient is too weak or too sick or too tired to continue life-prolonging treatments. At this stage, many patients and their families turn to hospice care for end-of-life and grief support.

What is hospice?

If you or someone you love has chosen hospice care or is considering doing so, it will help to learn all you can about how hospices work. Essentially, hospice is not a place, but a philosophy of care. Hospice care may be delivered in a special facility, in a hospital or nursing home, or in the patient's own home. Whatever the setting, hospices emphasize living rather than dying; patients and their families, rather than the illness; and quality of life, rather than length of life.

Sometimes patients are reluctant to pursue hospice care because they or their loved ones see it as giving up hope. This unfortunate view can be a roadblock to the kind of care that will give a patient true comfort in their final days. In reality, while hospice patients let go of the fight for a cure, hospices bring them another kind of hope – the hope of living a life of the highest quality possible, day by day, in the final stages of a terminal illness. Hospices help patients and their families approach death with acceptance rather than an attitude of defeat.

Hospice services

Using a multi-disciplinary approach, hospices provide comprehensive palliative (soothing, supportive) care for symptom relief as well as social, emotional, and spiritual support. Depending on the wishes of the patient and his or her family, hospice care may include any or all of the following:

  • Pain and symptom control: the primary goal of hospice care is to keep the patient as comfortable and pain-free as possible, without side effects or sacrificing mental alertness.
  • Spiritual care: while hospice is not a religious program in itself, it does recognize that people at the end of life often find great solace in spiritual beliefs and religious practices, and it offers support for patients and families in meeting those needs.
  • Home care or inpatient care: more than 90 percent of hospice patients prefer to remain in their own homes, and hospices strive to honor that wish. When inpatient care is needed temporarily, hospice home workers cooperate with hospital staff to ensure continuity of care.
  • Respite care: when necessary, hospice can provide respite care in a hospital or other inpatient facility, allowing the family a few days for a much-needed break from the round-the-clock care of the patient.
  • Bereavement care: after a hospice patient dies, specially trained members of the hospice care team work with surviving family members to help them through their grief.

Hospice professional staff and volunteers also provide other kinds of support on many levels, from educating patients and families about death and dying to running errands or staying with the patient while family members attend to other matters. With boundless compassion and empathy, hospice workers give patients the opportunity to live out their final days in the peaceful and loving presence of their families, and help families to cope with their grief throughout the bereavement process.

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Further sources of information

You may find our other articles in the Death and dying: a broader context section helpful too.

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