It was announced earlier this week that former President Jimmy Carter has stepped down hospice care. But what is hospice care and how can it provide comfort and support?

Hospice is for people nearing the end of life. Services are provided by a team of healthcare professionals who maximize the comfort of a terminally ill person by reducing pain and addressing physical, psychological, social and spiritual needs. To help families, hospice care also provides counselling, respite care and practical support.

Unlike other medical care, the focus of hospice care is not to cure the underlying disease. The goal is to support the highest possible quality of life regardless of the time that remains.

Who can benefit from hospice?

Hospice is for a terminally ill person who is expected to have six months or less to live. But hospice care can be provided as long as the person’s doctor and hospice care team certify that the condition remains life-limiting.

Many people who receive hospice care have cancerwhile others have other serious or advanced medical conditions such as heart disease-oneseedementia, kidney failure or chronic obstructive pulmonary disease.

Registering for hospice early can help you live better. Hospice reduces the burden on the family, reduces the family’s likelihood of having a complicated grief, and prepares family members for the death of their loved one. Hospice also allows for a patient to be cared for in a facility for a period of time, not because the patient needs it, but because the family caregiver needs a break. This is known as offloading.

Where is hospice care provided?

Most hospice care is provided at home – with a family member typically serving as the primary caregiver. However, hospice care is also available in hospitals, nursing homes, nursing homes and dedicated hospice facilities.

Who is involved in hospice?

If you are not receiving hospice care in a dedicated facility, hospice staff will make regular visits to your home or other settings. Hospice staff are on duty 24 hours a day, seven days a week.

A hospice care team typically includes:

• Doctors. A primary care physician and a hospice physician or medical director will oversee care. Each patient can choose to have their former primary care physician or a hospice physician as their primary physician.
• Nurses. Nurses will come to your or your relative’s home or other setting to provide care. They are also responsible for coordinating the hospice care team.
• Health aides in the home. Home aides can provide extra support with routine care, such as dressing, bathing and eating.
• Spiritual advisors. Pastors, ministers, lay clergy, or other spiritual counselors can provide spiritual care and guidance for the entire family.
• Social workers. Social workers provide advice and support. They can also provide referrals to other support systems.
• Pharmacists. Pharmacists provide medication supervision and suggestions for the most effective ways to relieve symptoms.
• Volunteers. Trained volunteers offer a range of services, including providing companionship or respite for relatives and helping with transport or other practical needs.
• Other professionals. Speech, physical and occupational therapists can provide therapy if needed.
• Grief counselors. Trained bereavement counselors offer support and guidance after the death of a loved one in hospice.

How is hospice financed?

Medicare, Medicaid, the Department of Veterans Affairs, and private insurance typically pay for hospice care. While each hospice program has its own policy regarding payment for care, services are often offered based on need rather than ability to pay. Ask about payment options before choosing a hospice program.

How do I choose a hospice program?

To find out about hospice programs, talk to doctors, nurses, social workers or counselors, or contact your local or state office on aging. Consider asking friends or neighbors for advice. The National Hospice and Palliative Care Organization also offers an online provider directory.

To evaluate a hospice program, consider asking:

• Is the hospice program Medicare certified? Is the program reviewed and licensed by the state or otherwise certified? Is the hospice program accredited by The Joint Commission?
• Who makes up the hospice care team and how are they trained or screened? Is the hospice medical director certified in hospice and palliative medicine?
• Is the hospice program not-for-profit or for-profit?
• Does the hospice program have a dedicated pharmacist to help adjust medications?
• Is there a hospice in a residential area?
• What services are offered to a person who is terminally ill? How are pain and other symptoms managed?
• How is hospice care provided after working hours?
• How long does it take to be accepted into the hospice care program?
• What services are offered to the family? What respite services are available for caregivers or caregivers? What bereavement services are available?
• Are volunteer services available?
• If circumstances change, can services be provided in other settings? Does the hospice have contracts with local nursing homes?
• Are hospice costs covered by insurance or other sources, such as Medicare?

Remember, hospice emphasizes care over cure. The goal is to provide comfort in the last months and days of life.

This article was written by Mayo Clinic staff. Find more health and medical information about mayoclinic.org.

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