The Truth About Hospice

The common misconception about hospice is that it's where people go to die.

That's far from the truth. Hospice isn't a “place,” but rather a healthcare service offered wherever a patient resides. And people can get that service well before they are on their death bed. In fact, studies prove that receiving hospice care earlier in one's illness can prolong life. A 2010 study published in the New England Journal of Medicine found that terminal lung cancer patients who began receiving hospice care immediately upon diagnosis not only were happier, more mobile and in less pain as the end neared, but also lived nearly three months longer than those who didn’t receive such care. Similar studies have found the same to be true for patients with heart failure and chronic lung disease.

November is Home Care & Hospice month, commemorating the fact that hospice services have been around since the 1970s. In the Puget Sound region, Providence Hospice of Seattle started the first hospice program in 1975. Yet many people don't know the truth about hospice.

Here are some basic facts:

• Hospice is paid for by Medicare, Medicaid and most insurance providers.

• Hospice care is provided to those who, in consultation with their physicians, have decided that supportive rather than curative care is desired. The focus of hospice is comfort and quality of life. Despite the association of hospice with terminal illness, the primary goal is to help people spend their time living as fully and completely as they wish, in their own familiar, comfortable surroundings, and in the company of family and friends.

• A patient must have a prognosis of 6 months to live or less to receive hospice services. Yet many live well beyond their six-month prognosis, in many cases because of the hospice care they received.

• Hospice care focuses on the whole person and all of their needs - physical, emotional, social and spiritual.

• Basic to the concept of hospice is an acknowledgment that death is a part of life and a belief that there are opportunities for growth in all stages of life, including the last stage.

“The focus of hospice is not so much on the actual dying event but really on looking at the whole family and trying to insure that we address symptoms and concerns that commonly arise in those last several months of life to impact the quality of their care and the quality of their life as well as hopefully impacting the whole end-of-life experience,” said Peg Rutchik, vice president of hospice services with Providence Hospice and Palliative Care.

Some 40 percent to 50 percent of patients served by the three organizations Rutchik oversees - Providence Hospice of Seattle, Hospice & Home Care of Snohomish County, and Providence SoundHomeCare & Hospice - die within the first two weeks of beginning hospice service. That's too late for them to receive the full benefits, Rutchik said.

“The most common thing we hear from families is that they wish they had been referred earlier,” she said.

That wasn't the case for Jack Warren, an Enumclaw man who has been receiving hospice care since January 2011. A Korean war Navy veteran, Warren is dying from heart and lung disease. But because Warren, who turns 81 on Nov. 13, has received hospice care, he has been able to work through many end-of-life issues that face veterans. He has worked with Providence Hospice of Seattle chaplain Greg Malone to come to terms with spiritual issues and he's received all the medical support he needs from hospice to remain in his home.

In addition to serving the patient, hospice benefits the family by offering education, support and grief services. Hospice nurses address patients' medical needs while social workers help patients and their families focus on personal issues that often arise at the end of one's life. Chaplains are there to address spiritual concerns. Patients also have access to hospice aides who can help with bathing, and volunteers to provide companion care. When appropriate, therapists may help with mobility, adaptive equipment and comfort-focused therapies.

“These are really intimate, significant events in people's lives,” Rutchik said. “Being part of the care is an honor and truly very profound.”

For more information about Providence Hospice and Palliative care, go to www.ProvidenceHospiceWashington.org.

As the number of hospice patients grows, so does the need for volunteers. If you are interested in learning more about volunteering opportunities with Providence Hospice, please contact Sandy Powers at sandy.powers@providence.org.

This article appeared in the November 2012 issue of Northwest Prime Time, the Puget Sound region’s monthly publication celebrating life after 50.