The Blessing of Hospice with Info for Writers

My friend Pastor Sandra called me one Sunday morning. Her mother was at Hospice, and she asked if I’d stop in, since she herself had a service to lead at her church. Of course, I went. When I arrived and explained who I was, one of the nurses came and sat with me, explaining that Mrs. Y had passed away within the hour. Her daughter had been called and would arrive after her Sunday services were complete. She asked if I wanted to see my friend’s mother and of course I agreed. As I sat with this lovely aged woman, I introduced myself silently – we had never met. I prayed for her, having both impromptu prayers come to mind, as well as Psalms and gospel reading from my Bible. Then I left, so that the staff could finish their preparations. Sandra would arrive shortly.

I am quite familiar with Hospice of Branford, CT, a wonderful facility, the first hospice site in the U.S., founded by Cicely Saunders, who came to U.S., to Yale, to implement a model after her hospice in G.B.

Several of my aunts and uncles went there as they reached the end of their final illness, cancer mainly. Hospice provides excellent palliative care, powerful medication to treat pain, alternative healing modalities. It also provides an open door wherein loved ones may come at any time to sit with a patient. If a patient improves and can go home, they may return if/when they relapse. Hospice provides support for families, and after death counsels them.

My dear Aunt Mary died at Hospice. I recall her asking, “Why does it take so long?” and wordlessly I kissed her cheek. Aunt Florence was with her when she took her last breath (I had to be at work). The fact that Mary did not die alone, that she was surrounded by loving staff, dear ones from her life, brought great solace during our time of mourning.

The first American Hospice. was opened in 1974 in Branford, Connecticut. Spanning four decades as the country’s first hospice, The Connecticut Hospice, Inc. is also the first palliative teaching hospital earning the national Joint Commission’s first “Advanced Palliative Certification.” Excellent rating is demonstrated in the highest ratio of care between nurses and patients in the country.  Nurses are trained through the Norma F. Pfriem International Hospice and Palliative Care Nursing Program.

The Connecticut Hospice, Inc., recognizes the complexity of the needs of patients with an irreversible illness and their families. While the control of physical pain and other physical symptoms is the central and primary concern for caregivers, it is not the only priority. The patient with an irreversible illness suffers from an array of emotional, spiritual, social and financial problems. The rationale for Hospice caregiving (staff and volunteers) is that it is impossible for any discipline to provide the range of services required. Through the team approach, Hospice helps patients and families attain optimum quality of life – with physician and clinical pharmacy rounds daily, house calls by physicians and medications delivered to the home.

Connecticut Hospice serves anyone in need — regardless of ability to pay. We provide inpatient and home care which empower the living to live fully and their family to see them as a person of mystery, beauty and strength. Contributions also pay for free care at the end of life, so that the Hospice patients and their families are not additionally burdened.  Info from © 2014 The Connecticut Hospice, Inc. 100 Double Beach Road, Branford, CT 06405


Frequently Asked Questions

  1. When should a decision about entering a hospice program be made and who should make it? At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Most hospices accept patients who have a life-expectancy of six months or less and who are referred by their personal physician.
  2. Should I wait for our physician to raise the possibility of hospice, or should I raise it first? The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.
  3. Is all hospice care the same? No.  Many communities have more than one hospice.  Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another.  To find the best hospice for your needs, ask your doctor, healthcare professionals, clergy, social workers or friends who have received care for a family member.  You may want to call or meet with the hospices and ask questions about their services.
  4. Can a hospice patient who shows signs of recovery be returned to regular medical treatment? Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.
  5. What does the hospice admission process involve? One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Most hospices have medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.
  6. Is there any special equipment or changes I have to make in my home before hospice care begins? Your hospice provider will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.
  7. How many family members or friends does it take to care for a patient at home? There’s no set number. One of the first things a hospice team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Hospice staff visit regularly and are always accessible to answer medical questions.
  8. Must someone be with the patient at all times?In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, hospice generally recommends someone be there continuously. While family and friends do deliver most of the care, hospices may have volunteers to assist with errands and to provide a break and time away for primary caregivers.
  9. What specific assistance does hospice provide home-based patients? Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness.
  10. Does hospice provide care 24 hours a day, 7 days a week? Hospice staff is on call for emergencies 24 hours a day. Hospice care does not include a nurse in the home 24/7. If you require more care than can be provided in the home, some hospices have their own inpatient facilities. Most communities have nursing homes, inpatient residential centers and hospitals with hospice care options.
  11. Does hospice do anything to make death come sooner? Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.
  12. Is caring for the patient at home the only place hospice care can be delivered? No. Hospice patients receive care in their personal residences, nursing homes, hospital hospice units and inpatient hospice centers.
  13. How does hospice “manage pain”? Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish, and they are sometimes joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.
  14. What is hospice’s success rate in battling pain? Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort they consider acceptable.
  15. Will medications prevent the patient from being able to talk or know what’s happening? Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.
  16. Is hospice affiliated with any religious organization? No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.
  17. Is hospice care covered by insurance? Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 47 states, and by most private insurance providers. To be sure of coverage, families should, of course, check with their employer or health insurance provider.
  18. If the patient is eligible for Medicare, will there be any additional expense to be paid? The Medicare Hospice Benefit covers the full scope of medical and support services for a life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services. This benefit covers almost all aspects of hospice care with little expense to the patient or family.
  19. If the patient is not covered by Medicare or any other health insurance, will hospice still provide care? The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, some hospices will provide for anyone who cannot pay using money raised from the community or from memorial or foundation gifts.
  20. Does hospice provide any help to the family after the patient dies? Most hospices provide continuing contact and support for caregivers for at least a year following the death of a loved one. Many hospices also sponsor bereavement groups and support for anyone in the community who has experienced a death of a family member, a friend, or similar losses.

About @LatelaMary

Author of 14 self-help books, five still available: Prepare Him Room, Ten Steps to Peace, Healing the Abusive Family, Moments for Mothers. Breaking the Boxes: critique of institutions vs. individuals. Work-in-progress: Memoir (Sorting out Secrets)
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