Q. I’m going to visit a friend who is receiving hospice care at home. I don’t know exactly how hospice works, and would feel more comfortable if I had some basic information. Can you educate me?

As I researched the answer to your question, I was astonished to learn that about 45 percent of all deaths in the United States involve hospice care, with the majority of patients dying at home, according to the National Hospice and Palliative Care Organization. The first hospice program was launched back in 1974, and there are now more than 5,300 programs (covering every state) throughout the country. Hospice’s mission is providing compassionate care for the terminally ill. The goal is to improve quality of life, keep the patient comfortable and pain-free and ease other symptoms and distress. An interdisciplinary team offers pain management; drugs and treatment; and emotional, psychological and spiritual help. The team also teaches the family how to provide care. Hospice staffs are on call 24 hours a day, seven days a week.

Care can be provided not only in the patient’s own home, but also wherever the patient resides, such as in a nursing home or long-term-care facility -- as well as at freestanding hospice facilities or in hospitals. The hospice team may include the patient’s doctor, the hospice physician, a registered nurse, home health aide, chaplain, social worker and volunteers. The latter may perform tasks such as transportation or errands, or just “be there” for both patient and family. Volunteers can give family members respite from the draining stress and sadness each day brings.

An estimated 1.6 million patients received hospice services in the U.S. in 2012. In approximately 36 percent of cases, patients received less than seven days of care; 27 percent of patients received 8-29 days; 17 percent spent 30-89 days in hospice care; 20 percent spent 90-180+ days or more. The overwhelming majority of patients were 65 or older. Few people realize, however, that hospice help does not stop when the patient dies. Trained bereavement counselors are available for up to a year following the death to help grieving family members deal with the loss.

Hospice care at home (or other places where the patient resides) is covered by Medicare, Medicaid and most private insurance plans. However, coverage may not be available at other locations.

I know personally how supportive hospice care can be. Hospice helped two of my cousins to die with dignity.


If you have a question for Florence, please email her at fisaacs@florenceisaacs.com.

Florence Isaacs is the author of several books on etiquette, including My Deepest Sympathies: Meaningful Sentiments for Condolence Notes.... She writes two advice blogs for Legacy.com: Sincere Condolences and Widow in the World, a blog for bereaved spouses and partners.

Image via Flickr Creative Commons / Mayr

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