Hospice is a topic that frequently surfaces when it comes to discussions about Living Trusts and end-of-life care. With our large, aging babyboomer population and potential for profIt, the hospice industry has exploded over the last few years, yet it remains largely unregulated, and the level of care varies significantly between for-profit and nonprofit hospice organizations.
Yet the reality is that people tend not to research hospice care until they need it. Death and dying remain unpleasant topics and there is a lot of misconceptions about this end-of-life care.
Here are 5 common myths about hospice.
- Myth No. 1: Hospice places a time limit on patient stays and hastens death. Many people mistakenly believe that to receive hospice care, the patient must be expected to live fewer than six months. This misconception can be traced back to Medicare, which gives assistance in the form of benefit periods. Each initial benefit period lasts 90 days and Medicare estimates people in hospice usually only need two periods. If after six months, however, you are still in need of hospice services, you can receive an unlimited number of 60-day benefit periods if a hospice director or doctor recertifies that you’re terminally ill. If you outlive the six-month Medicare estimation, you can go off hospice care and come back when you need it.
- Myth No. 2: People have to go to hospice centers in order to receive hospice care. Hospice care is a philosophy on death and dying, not a place. People are able to receive hospice care where they’re most comfortable--in their homes or in licensed facilities.
- Myth No. 3: Hospice care requires you to stop taking medications. Many people fear hospice because they know that stopping medications can mean accelerated death. Hospice focuses on a relief-based, rather than a curative approach; but the decision to halt medication is usually left up to the patient.
- Myth No. 4: Hospice depends on sedation as a major way to manage patient pain. For most people facing a terminal illness, it's not death they fear most, but the processes and pains of dying. Many people fear that hospice workers intentionally sedate patients as the preferred method for dealing with pain. If patients have chronic pain, they are started at low doses, and if the low dose works, they remain at that dosage. Pain management is only increased if the patient is still suffering from pain. Patients can also take advantage of spiritual counseling, and hospice provides bereavement assistance for at least a year following a patient’s death.
- Myth No. 5: Once you’re enrolled in a hospice program, there’s no turning back. Patients can stop hospice treatment at any time and return to a curative-based approach. There may be a new treatment or they may be showing signs of improvement. For whatever reason, it’s a patient’s choice to make. If the patient wants to return to hospice, Medicare generally pays for the extended coverage.
Death is beginning to be viewed as a natural life process that can be managed. Disease can be monitored, which helps doctors make informed estimates about a patient’s life expectancy. Healthcare workers are more enlightened about helping patients and their families deal with terminal illness and prepare for death.
When family members transition to hospice, it is not about giving up or hastening death, but about making rational decisions about how and where to spend their final days—in many cases, pain-free, in the comfort of their own homes, surrounded by their families.