Hospice

A **hospice** is a type of medical treatment that helps take care of people who are very sick and have an illness that they will not be able to heal from. People who stay in hospices are expected to die soon, but sometimes they get better. Hospices are different from other medicinal treatments because they mostly try to make people feel better instead of trying to cure them. Hospice tries to allow people to die with as little pain as possible. A member of the hospice team visits regularly, and someone is usually always available by phone — 24 hours a day, seven days a week. Hospice may be covered by Medicare.

Most hospice care is provided at home — with a family member typically serving as the primary caregiver. However, hospice care is also available at hospitals, nursing homes, assisted living facilities and dedicated hospice facilities.

Hospices have doctors, nurses, and other people who go to patients houses, nursing homes and hospitals to talk to people who want to use hospice medicine.

In the United States hospice treatment is a benefit provided by the federal government since 1982. Under the Medicare Hospice Benefit, a person certified by two physicians to have less than six months to live can get specialized hospice services through various insurance programs.

## History

The Hospice movement was started in England in the 1950s by a nurse named Dame Cicely Saunders. The word **Dame** at the start of her name means that she did such good work starting hospices that the Queen of England made her a female knight.

A different nurse named Florence Wald brought hospice medicine to the United States because she worked with Dame Cicely Saunders and liked what she did.

## Types of Hospice Care

There are four types of hospice care, and all of them focus on different stages of a patient’s needs.

**In-Home Hospice **: The first level of hospice care is in-home hospice, which means that hospice staff will come to a patient’s home to provide care. This type of hospice care is typically used in the early stages of hospice, helping patients transition from a hospital to their homes.
**Continuous Care**: The second level of hospice care is continuous care, which is in-home care with 24/7 support. With constant care, a patient has a member of hospice staff on hand at all times to help assist in symptom management.

**In-Patient Hospice**: The third level of hospice care is in-patient hospice care. While it’s never a patient’s first choice to be in a hospital, away from the comfort of their home, there are times when symptoms become too much to manage even by continuous in-home care. In-patient hospice allows a patient to be observed by nurses and physicians around the clock, ready at a moment’s notice to treat advanced symptoms and offer expert insights and care. In-patient hospice facilities tend to be calmer and more “home-like” than regular hospital visits to replicate a familiar setting’s comfort.

**Respite Care**: The fourth and final level of hospice care is respite care. Respite care exists as a sort of hybrid between in-patient and in-home or continuous home care. The point of respite care is primarily to offer relief to caregivers. Especially for those with no medical background, becoming a primary caregiver to a hospice patient can be too physically taxing and emotionally draining. Respite care allows caregivers relief from the responsibility of having a hospice patient in their care for as many as five days and nights so they can rest.