When we think about a hospice care facility, we envision a dark and dreary place, where death looms like a gray cloud signaling the end. But modern-day hospice founder, Dame Cicely Saunders, thought differently. She coined the term ‘total pain,’ from her view that “dying people have physical, spiritual, psychological, and social pain that must be treated…” She believed strongly that dying isn’t dead. It is still living, and every person deserves to live through the dying process with dignity, love, inclusion –and light.
The ideal hospice model, whether it takes place within the patient’s home, the hospital, a nursing home, or a specialized facility, provides numerous comfort-care and palliative services for every phase of those final months of a person’s life.
There are four levels of hospice care as defined by Medicare: routine home care, continuous home care, general inpatient care, and respite care. A patient’s doctor will determine if hospice care is the right choice for him/her. Using a team approach, each level is designed to relieve the family and the patient of the challenges associated with that stage of care.
Level 1: Routine Home Care
Routine home care can take place in the home as well as a nursing or assisted living facility. It includes the most basic services such as nursing, physician care, social services, counseling (i.e. spiritual, dietary, bereavement, etc.), medications, medical supplies, lab work, and therapy services.
Level 2: Continuous Home Care
With continuous home care, a nurse remains with the patient in his home environment for eight to twenty-four hours per day. This is a short-term level of care to relieve the patient of a medical crisis, unrelieved pain, and other severe symptoms connected to the diagnosis.
Level 3: General Inpatient Care
Patients are moved to an inpatient facility when severe symptoms like respiratory distress, sudden deterioration, and uncontrollable nausea and vomiting cannot be managed at home. Nurses are available around the clock to administer medications, treatments, and emotional support to make the patient more comfortable. Once the situation is stabilized, the patient returns to his/her home environment.
Level 4: Respite Care
Respite care offers temporary relief (up to five days) to family members and other caregivers that need a break due to personal illness, stress, travel, etc. A patient may be temporarily admitted to an inpatient facility.
Hospice: Comfort and Palliative Care = Dignity
Treating a person with dignity during his/her most vulnerable time of life is not just a kindness, it’s an obligation.
As one family member observed during her father’s final month in hospice care, “The nurse wiped the sweat off his body, brushed his teeth, changed his sheets, and checked-in on him every hour. She treated him like a person.”
A living person.