Hospice care is a service provided to people who are terminally ill and generally have six months or less to live. It focuses on palliative (comfort) care.
That means measures will be taken to alleviate pain and discomfort, but aggressive medical treatment for the purpose of prolonging life will not be given.
Hospice allows terminally-ill patients and their families to experience the end of life together in the comfort and security of home or a home-like setting. Hospice emphasizes the quality of life instead of its duration by treating the person physically, emotionally, socially and spiritually, instead of simply treating the disease. And it focuses on helping the entire family, instead of just the individual.
Hospice is covered by most insurance plans and is an option for those who qualify for Medicare and Medicaid benefits.
Most people who use hospice care are over age 65 and are entitled to the Medicare Hospice Benefit. This benefit covers virtually all hospice services and requires little, if any, out-of-pocket costs. This means that there are no financial burdens incurred by the family, in sharp contrast to the huge financial expenses at the end of life which are incurred when hospice is not used. Hospice services are also provided by Medicaid and most insurance companies.
Palliative care is specialized medical care for people with life-limiting illnesses. It means taking care of the whole person – body, mind, spirit, heart and soul.
Palliative care looks at dying as something natural and personal.
The goal of palliative care is to improve the quality of life for the patient and the family. The focus is providing relief from the symptoms, pain, and stress of the illness.
Palliative care helps patients to achieve the best possible quality of life right up until the end of life. Bereavement programs are often part of the comprehensive care offered as part of palliative care.
Two Types of Advance Directives
Documents that state your wishes about the types of medical treatment you want, or don’t want, if you are unable to communicate these instructions yourself are called Advance Directives.
There are two types of advance directives: the Living Will and the Durable Power of Attorney for Health Care.
A Living Will contains written instructions explaining the type of health care treatment you prefer to receive if you cannot communicate for yourself.
These instructions will be followed in only three situations: 1) when you have a terminal illness and death is imminent, 2) when you are in a coma (not necessarily brain damaged) with no reasonable expectation of regaining consciousness, or 3) if you are in a persistent vegetative state (there is brain damage) with no reasonable expectation of regaining cognitive function.
A Living Will should not be confused with the legal documents you create which distribute your assets upon death. You do not need legal counsel to prepare a Living Will.
A Durable Power of Attorney for Health Care allows you to identify a specific person who will act as your personal agent if you cannot communicate for yourself. Your agent will make sure your health care providers are informed of the type of care you wish to receive by referring to your Living Will and to past personal conversations the two of you shared. Your personal agent can speak for you in any health care situation when you are unable to communicate for yourself. For instance; if you were temporarily unconscious due to an illness or accident, declared mentally incompetent by the court, under anesthesia, or in a variety of other scenarios. You do not need legal counsel to prepare a Durable Power of Attorney for Health Care.
It is extremely important to speak with your loved ones about your final health care choices. If your family does not understand your thoughts and beliefs behind your decisions, they may not follow your instructions.