Why Use Hospice Care in Savannah?

In a large medical study in 2004 involving thousands of Americans, people were asked if they had the choice, where and how they would die, and what were their greatest fears about dying. The answers were overwhelmingly consistent. Most people want to die at home, surrounded by family, awake and aware of their surroundings; the greatest fear is of being in pain. Sadly, studies also show that most Americans still die in hospitals, and many people still decline and die in pain. Our fear of dying interferes with our recognizing that we are near the close of life, and keeps us from making plans to make sure that we get what we want.

One way of assuring the best chance for a transition from life to death with expert pain and symptom management and emotional and spiritual support for ourselves and our families is hospice care. Hospice programs provide supportive care to terminally ill patients 24 hours a day, 7 days a week, who have a prognosis of six months or less. This care can be provided at home, in assisted living facilities, in nursing homes, in hospice inpatient facilities if available, and in urgent cases even in a hospital room. This care is provided by a skilled team, including specially trained physicians, nurses, certified nursing assistants, chaplains, social workers, volunteers and bereavement counselors. The mission of any hospice care is to alleviate suffering and to improve the quality of life of patients who are expected to die, while addressing the specific needs, wishes and goals of each patient and family served. The cost of hospice care is covered by Medicare and most private insurance; they pay a set amount per day for the care. All patient needs are met within this amount, including medications for maintaining comfort, and medical equipment (such as hospital bed, wheelchair, and oxygen) needed to improve quality of life for the patient or caregivers. Not for profit hospice organizations offer care for patients without ability to pay, and count on charitable donations to cover extra services to help patients, such as music or massage therapy.

An important thing to understand about hospice care is that a patient’s own physician is still involved in the patient’s care, and with the assistance of the hospice physician directs the hospice team that cares for the patient. Some people feel that if their doctor brings up hospice, that they are “giving up” on them. In fact, a sensitive and skillful physician will recognize the appropriate time to encourage his or her patients to begin to plan for the end of life, giving those patients time to concentrate on quality of remaining life when cure of disease is no longer possible. A physician who wants patients to experience the best end of life care that can be offered is acting in generosity and tenderness, and understands that to see death as part of the normal process of living is responsible and honest, not an abandonment of hope.

A common misunderstanding about hospice care is a fear that if someone elects hospice, they will die “faster.” In truth, hospice affirms life and neither hastens nor postpones death. In fact, many people with chronic disease who have been declining steadily and have had to be hospitalized multiple times, actually improve under hospice care. To live with relief of pain, anxiety and other debilitating symptoms can make people feel so much better that they live longer than expected. It is also a misconception that everyone in hospice care is automatically started on strong pain medicines. In truth, medication is tailored to each patient’s need, desire, and tolerance, and the patient’s physician stays in charge of all medication orders.

Once the question of “when” to elect hospice care is decided, the question of “how” to choose hospice care becomes important. A referral for hospice services can be initiated by a patient’s physician or by the patient or family themselves. They should look for a hospice which is staffed with well trained professionals: doctors, nurses, chaplains, social workers, certified nursing assistants, volunteers, bereavement counselors and ancillary services. They should consider the opinion of their physicians and the reputation the hospice enjoys in the community. They should consider the availability of inpatient respite care or inpatient and in-home crisis care when patient symptoms cannot be managed in a home care setting. They should inquire as to the board certification of the hospice medical director, indicating special expertise in caring for patients at the end of life. The journey toward death is understandably the hardest one that we make in life. An expert hospice team can travel with us, guiding, assisting and compassionately caring all the way.