Hospice provides compassionate, dignified care for a patient who is going to die. The philosophy is to provide supportive, understanding, and pain-free care to a terminally ill patient. Initiated in 1967 in London, it stems from the word "hospitality" or rest for a weary traveler. However, it should be noted hospice supports life and not the hastening of death. Hospice is usually initiated when the terminally ill patient has less than 6 months left to live. However, patients and families can start discussing hospice even before the 6 month time point. If necessary, hospice can be extended if a patient lives longer than 6 months. In addition, if the patient improves, they may leave hospice if they get better (or return to hospice at a later date if they get sick again).
Hospice care usually takes place at home (approximately 90% of the time). In this case, family and friends take a majority of the responsibility of the care of the patient. However, a nurse or doctor may come to the household a few times per week to make sure the patient is comfortable, pain free, and to help the family in any way possible. If there was an emergency at home, an on-call nurse or doctor is available 24 hours a day/7 days a week for any possible questions or problems if they should arise. Physician, spiritual, and community service care is also available to provide social and emotional support if the patient of family should so desire.
On the other hand, some hospice care takes place in an in-patient setting (such as a hospital, nursing home, or private hospice facility) where the patient would be taken care of by an in-patient team. This in-patient team will usually involved a doctor, nurse, social workers, and/or members of the clergy.
There is also concern for the care of the friends and family. If the caretakers of the patient become too exhausted and emotionally drained from the process, they may take a "respite" or time off from their caretaker duties (usually for 5 days). In this scenario, a nurse or other healthcare provider would take care of the patient in an in-patient setting. During this period, the family may take much needed time away from their responsibilities to heal and take care of themselves until they are ready to take care of their loved one once again.
The decision to agree to hospice should be discussed by the patient, their family, and the patient's doctor. These arrangements can then be initiated by the family doctor or other qualified health care professional. At that point, the desires of the patient and loved ones can be discussed as to what type of hospice would be most beneficial to all parties involved and what services the patient wants (i.e. spiritual support, physical therapy, etc) throughout their hospice experience.
Finally, hospice also provides bereavement services. These are usually available up to 13 months after the death of the patient. These services provide support for surviving loved ones and to help them through the grieving process. Trained councilors, clergy, and volunteers are usually available to help loved ones through this continued difficult and emotional time.
For additional details and services concerning hospice, please visit the below listed informative websites.
National Hospice and Palliative Care Organization (NHPCO)
http://www.nhpco.org
International Association for Hospice and Palliative Care
http://www.hospicecare.com
Hospice Assocation of America (HAA)
http://www.hahc.org
Hospice Net
http://www.hospicenet.org
The American Cancer society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov