Articles

Celebrating Hospice
A Quiet Health Care "Revolution"

When we think of health care breakthroughs, we usually think of new surgical procedures or miracle drugs, not hospice care. Hospice's story, however, is unique and remarkable. In just three decades, hospice has quietly revolutionized the way people die in America by honoring wishes and bringing peace, dignity, and comfort to millions of patients and families. Hospice of Southeastern Connecticut has been a part of this health care revolution by providing end-of-life care for 17 years.

November 2002 is National Hospice Month, when hospices raise awareness in their communities, honor and support their patients and families, and recognize the contributions of professionals and volunteers who provide hospice care. This year, National Hospice Month is even more significant because it marks a milestone in American health care: the twentieth anniversary of the Medicare Hospice Benefit.

The hospice approach and philosophy took hold in the 1970's, and with the establishment of a hospice benefit under Medicare in 1982, quality end-of-life care soon became increasingly accessible for a rapidly growing number of patients and families in the 1980s and 1990s.

In 1975 hospice programs served fewer than 6,000 patients a year. Now, in the United States, there are approximately 3,200 hospice locations serving an estimated 775,000 patients and families each year, and less than one percent of Medicare beneficiaries live in areas without access to a hospice program.

When patients and families choose hospice, they receive care unlike any other. Hospice goes to the patient, treats pain and symptoms with aggressive medical care, and eases the emotional and spiritual suffering of patients, families, and loved ones. A team of trained and caring experts that include doctors, nurses, social workers, chaplains, home health aides, volunteers, and bereavement counselors make this care possible. Under Medicare, most private insurance plans, HMOs, and other managed care organizations; hospice care is available to beneficiaries and their families at little or no cost. In addition, through community contributions, memorial donations, and foundation gifts, many hospices are able to care for patients who have no insurance coverage.

Even so, challenges remain. The National Hospice and Palliative Care Organization estimate that for every patient who is currently receiving hospice care, there are two more who could benefit. What accounts for this? Primarily, lack of awareness, and the belief that hospice is only for elderly patients with cancer, who are in the very last days of life. The reality is that hospice accepts patients with any life-limiting illness, of any age, and who may have many weeks or months of good quality of life ahead of them.

This year, a survey conducted for the National Hospice and Palliative Care Organization, found that only 15 percent of Americans know that Medicare is the primary source of coverage for hospice. Only two out of five believe that most specialized end-of-life care is paid for by health insurance.

At the same time, those polled noted the importance of information and guidance from end-of-life experts for patients diagnosed with life-limiting conditions. Nearly nine out of ten Americans (88 percent) believe that patients with a life-limiting diagnosis would benefit from a consultation with end-of-life specialists to complement the care of their own physician, citing more control over end-of-life decisions, improving the patient's quality of life, and diminishing the financial impact of terminal illness as the expected benefit.