AMARILLO – A terminal illness diagnosis may mean the doctor can no longer help the patient, but care doesn’t stop just because there is no cure, said a Texas Cooperative Extension specialist.

Hospice is known as “care beyond the cure,” said Andrew B. Crocker, Extension gerontology health specialist here.

“Hospice” stems from the Latin word hospitium, meaning guesthouse, Crocker said. While it originally described a shelter for weary and sick travelers, today about 80 percent of hospice care is provided in the patient’s home, a family member’s home or nursing home.

Hospice is not a place, but a concept of care designed to provide comfort and support to patients and their families when an illness no longer responds to treatment, he said. The goal of hospice care is to improve the quality of a patient’s last days by offering comfort and dignity. It neither prolongs life nor hastens death.

The patient is not the only one who benefits from hospice care, Crocker said. Care is extended to family and friends to help deal with the emotional, social and spiritual impact of disease. It also offers bereavement and counseling services to families before and after a patient’s death.

Patients are usually referred to hospice when life expectancy is six months or less, Crocker said. A patient must have a doctor’s referral to enter hospice, but the patient, family and friends can initiate the process. Before providing care, hospice personnel meet with the patient’s personal health provider and a hospice physician to discuss patient history, current physical symptoms and life expectancy. After this initial meeting, hospice staff set up a meeting with the patient and family.

Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management, Crocker said. Care is usually provided by a team-oriented group of specially trained individuals.

The staff will discuss pain and comfort levels, support systems, financial and insurance resources, medications and equipment needs, he said. A “plan of care” is then developed for the patient and is regularly reviewed and revised according to patient condition.

Hospice is usually paid for through Medicare, Medicaid or a private insurer, Crocker said. More than 90 percent of U.S. hospices are certified by Medicare. The hospice benefit is available to Medicare beneficiaries who receive Part A inpatient hospital service coverage, he said.

“It is your right as a consumer to choose or deny hospice services,” Crocker said. “Choosing hospice, as well as choosing your hospice provider, is an important decision for your end-of-life care.”

To determine if hospice care is right for a patient and select a provider, he suggested asking the following questions:

– What services are provided?

– What kind of support is available to the family/caregiver?

– What roles do the attending physician and hospice play?

– How are services provided after hours?

– How and where does hospice provide short-term inpatient care?

– Can hospice be brought into a nursing home or long-term care facility?

If the patient’s health improves or the illness goes into remission, the health provider may feel hospice care is no longer needed and will not recertify the patient at that time. The hospice patient also has the right to stop getting hospice care for any reason.

“Hospice care is meant to ease the transition from life to death for both the patient and family,” Crocker said. “It is always important to remember there is care beyond a cure for persons with a terminal illness.”

For more information, contact The National Hospice and Palliative Care Organization at http://www.nhpco.org .

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