SETTING THE MYTHS STRAIGHT FOR HOSPICE
Myth #1 Hospice is a place.
Hospice care takes place wherever the need exists—usually in the patient's home. About 80% of hospice care takes place in the home. Services can also be delivered in a nursing home, assisted living facility or a residential hospice facility.
Myth #2 Hospice is paid for by the patient.
Medicare covers the hospice benefit for those who qualify. For those on private pay insurance, hospice is often a benefit. Most people who use hospice are over 65 and are entitled to the Medicare Hospice Benefit. This benefit covers virtually all hospice services and requires no out-of-pocket expenditures. This coverage reduces the family's financial burdens, and hospice care can be far less expensive than other end-of-life care.
Myth #3 Going into a hospice program hastens death.
Hospice neither hastens nor prolongs death; rather, it allows the death process to proceed at a normal and natural pace. Hospice provides presence and specialized knowledge during the dying process just as any specialist would provide. Hospice also provides personalized services and a caring community so that patients and families can attain the necessary preparation for a death that is satisfactory to them.
Myth #4 Hospice is only for people with cancer.
More than one-fifth of hospice patients nationwide have diagnoses other than cancer. In urban areas, hospices serve a large number of HIV/AIDS patients. Increasingly, hospices are also serving families coping with the end stages of chronic diseases, such as emphysema, Alzheimer's, cardiovascular, and neuromuscular diseases.
Myth #5 Hospice is only for old people.
Although the majority of hospice patients are older, hospices serve patients of all ages. Many hospices offer clinical staff with expertise in pediatric hospice care.
Myth #6 Hospice is only for dying people.
Hospice helps people at many levels of their life-limiting illness, including pain and symptom management, and emotional and educational support. As a family-centered concept of care, hospice focuses as much on the grieving family as on the dying patients. Most hospices make their grief services available to the community-at-large, serving schools, churches and the workplace.
Myth #7 Hospice can help only when family members are available to provide care.
Recognizing that terminally ill people may live alone or with family members unable to provide care, many hospices coordinate community resources to make home care possible; or, they help to find an alternative location where the patient can safely receive care.
Myth #8 Hospice is for people who don't need a high level of care.
Hospice care is serious medicine. Most hospices are Medicare-certified, requiring that they employ experienced medical and nursing personnel with skills in symptom control. Hospices offer state-of-the-art palliative care, using advanced technologies to prevent or alleviate distressing symptoms.
Myth #9 Hospice is only for people who can accept death.
While those affected by terminal illness struggle to come to terms with death, hospices generally help them find their way at their own speed. Many hospices welcome inquiries from families who are unsure about their needs and preferences. Hospice staff are readily available to discuss all options and to facilitate family decisions.
Myth #10 Hospice is not covered by managed care.
Although managed care organizations (MCOs) are not required to include hospice coverage, Medicare beneficiaries can use their Medicare hospice benefit anytime, anywhere they choose. They are not locked into end-of-life services offered or not offered by the MCOs. On the other hand, those under 65 are confined to their MCO's services, but are likely to gain access to hospice care upon inquiry.
Myth #11 Hospice is for when there is no hope.
When death is in sight, there are two options: submit without hope or live life as fully as ever until the end. The gift of hospice is its capacity to help families discover how much can be shared at the end of life through personal and spiritual connections that often are not made without assistance. It is no wonder that many family members can look back upon their hospice experience with the knowledge that everything possible was done toward a peaceful death.
Myth #12 Hospice patients become addicted to drugs.
In hospice, a major focus is pain control and comfort. Drugs are just one part of symptom control and are used in the lowest dose possible to get the patient comfortable.
Myth #13 Once you sign on to a hospice program, there's no getting out of it.
If a person chooses hospice care and their condition improves, they may sign out of hospice and go back to aggressive treatment or live their life as they see fit. When the need for hospice arises in the future, the person may sign back in to hospice.
Myth #14 Hospice patients must have a Do Not Resuscitate (DNR) order.
While most hospice patients have a DNR order, it is not required for hospice care.
Myth #15 Hospices save money by not working to cure the patient.
In hospice, the patient has already decided to forgo aggressive treatment and to focus on remaining comfortable and living their remaining days to the fullest. The patient's pain is managed so they are comfortable and able to be with their loved ones.
Myth #16 Hospice is only for people who are just days away from death.
Generally, the prognosis for entry into hospice is a life expectancy of six months if the disease runs its "normal" course. However, people may enter hospice at various stages in their disease process.
Myth #17 I have to go into the Hospice program my doctor recommends.
The only restriction you may have for choosing which Hospice program to enter may be your insurance company. Otherwise, the choice is always up to you and your family.
(extracted from "Debunking the Myths of Hospice" by Naomi Naierman, www.partnershipforcaring.org)