Here's What You Need To Know About Hospice Care

As a geriatrician who works mostly with people in their 80s and 90s, my job often includes caring for patients during their final days—helping both them and their families through one of the most difficult chapters of life. And though this process is never easy, there is one service that, whenever appropriate, I try to refer my patients and their loved ones to: hospice. In some cases, the suggestion is met with understanding, but more often than not, I have to explain its true value and the reasons why it may be right for someone.

Many times, people don’t fully know what hospice is, or they think that it’s something that’s just available to patients with advanced diseases who only have days left to live. In reality, hospice is for anyone with any number of life-limiting diagnoses. It’s a way to support patients at the end of life, giving them comfort and options that they may not know are available.

Here are 5 things I wish you knew about hospice care.

1. Hospice can maximize the quality of the life you have left

When people assume that hospice is just where you go to die, they’re missing the important point that it can often offer patients a far better quality of life, at the end of life. Hospice care can help relieve symptoms, provide comfort measures, and offer emotional and spiritual support. It also tends to give patients a sense of dignity and offers them options for their care. For example, if you’ve been in and out of the hospital repeatedly but your health keeps declining and you’re tired of the revolving-door visits, you may choose to manage your symptoms at home with hospice doctors or nurses, allowing you to maximize your time with family.

2. You may be eligible for care for up to six months

Many people have the perception that hospice can only be administered during the final days of life, but if you wait that long, you won’t fully experience its many benefits. Hospice is actually designed for patients with life-limiting diagnoses whose doctors have given a prognosis of six months or less. Patients and their families can benefit from a variety of services during this time, including education on caregiving, emotional and spiritual support, and more. Unfortunately, many are referred too late to experience all that hospice care has to offer.

3. Most people receive care at home, not at in-patient facilities

Hospice isn’t a destination, it’s a team of providers. The goal of hospice is to keep patients at home with their loved ones, with assistance from a multidisciplinary team that provides in-home care. Patients appreciate being surrounded by relatives and familiar surroundings, rather than spending their final days and weeks in a hospital room.

These services can also deliver durable medical equipment to your home, like hospital beds or wheelchairs. And since health care providers come to you, there’s no need to worry about the tricky logistics of traveling to a doctor or specialist. A range of team members—doctors, nurses, therapists, counselors, chaplains, and volunteers—can all help with pain management and other physical, emotional, and spiritual needs.

4. Hospice also supports family members

Many people don’t realize this, but hospice services are for family members, as well as patients. Hospice volunteers can teach you how to care for your loved one. They can also provide respite care when you need a break from caregiving.

Counselors and chaplains often help hospice patients come to terms with dying, but they also provide support for family members who are having trouble coping with an impending loss. Emotional support from hospice extends one year beyond the passing of a patient and includes access to bereavement counselors. That’s a really valuable benefit for families.

5. People of all ages may be eligible for hospice

You don’t have to be an older adult to qualify; hospice also supports younger people with life-limiting conditions, such as advanced cancer.

And although you might never need hospice care, life is unpredictable, so it’s best to be prepared. Whether you’re in your 20s or your 90s, creating an advance directive lets people know your preferences for care at the end of your life. In addition to the well-known do not resuscitate (DNR) order, there are many other variables, like ventilators, feeding tubes, wanting to be hospitalized or not, and wanting life-prolonging treatments or just comfort measures to consider. Sharing your wishes with your loved ones can help them feel more empowered when the time comes.

It’s also wise to choose a designated health care proxy, which is someone who can make medical decisions on your behalf in the event you’re unable to. You don’t need a lawyer to designate this person; it’s a simple form you can easily find online.

The best time to discuss these matters is when you’re healthy. Your doctor can fill out a form called Medical Orders for Life-Sustaining Treatment, or MOLST, which contains your advance directives. It’s valid in homes, hospitals, nursing homes, and at assisted living facilities. It’s an easily accessible, visible way to know what someone’s wishes are.

• Meet Dr. Mia Clar, geriatric medicine specialist.
• Do you need a living will? One chat every family should have.
• Debating longevity—is living longer good for us?
• Learn more about Northwell’s Hospice Care Network.