How Hospice Has Changed, And Why It’s Better Today

Hospice services available today to residents of Dubuque and elsewhere offer quite a lot for patients, especially when compared to hospice care in the past that pretty much consisted of a spare bed in a hospital or private home.

People who receive hospice services today now can access a variety of services designed to make them as comfortable as possible in such a difficult time. They also can be offered other resources including social workers, counselors, and even massage service.

At Above and Beyond Home Health Care and Hospice, the staff works hard to make sure all clients receive quality care to help their medical needs along with support to help their quality of life. While some hospice programs take place at a specialized medical facility, we allow patients to live independently in their own homes. Some have their own caregivers, such as family members or close friends. Others use the services of our caregivers and other therapists.

Having this level of independence as long as possible is helpful in keeping people’s spirits up. Though it’s a difficult time, some people are able to make the best of the experience. They are able to make peace with their family, make final arrangements, and make sure their family is financially secure.

Assistance from other medical professionals can also be useful, including massage therapists who can help people relax; physical therapists who can offer tips on rebuilding and using muscles; and occupational therapists who can help people learn or relearn useful tasks, everything from getting in and out of bed safely to good grooming. All of these skills can be useful if someone’s coordination is declining.

Hospice services are also considered one example of palliative care, a medical philosophy that focuses more on helping achieve quality of life vs. “finding a cure.” For instance, allowing a patient to live at their own home until their death rather than in a noisy, scary hospital or rehabilitation facility could be more appealing to someone. They will especially enjoy spending their final days surrounded by loved ones and familiar possessions.

Hospice history

People following the evolution of medical care will tell you that modern hospice care is quite different than it was even a decade ago, let alone a century ago.

For one thing, more people are using hospice services, which can speak to more awareness and more appreciation of being able to offer people extra support at the end of their life.

The National Center for Biotechnology Information, part of the U.S. National Library of Medicine, said hospice services nationally increased between 2000 and 2010. People over 65 using Medicare using hospice grew 15.9 percent in 2000 to 32.3 percent in 2010. The highest increase in hospice services was in the age of 85 or older.

More than half received services for less than a week but others received them for months.

Others were disenrolled, which means the services didn’t continue, such as if they either recovered from what was believed to be a terminal condition or they decided not to continue services.

Many hospice patients were battling cancer, but others were battling dementia or other conditions that were deemed terminal.

Hospice Care Is Increasing

Health Affairs, a health journal, said hospice use tripled between 1991-1992 and 1999-2000. At that time, much of the hospice patients were found at nursing homes and generally received services over a short period of time. But it also said that hospice use overall was low – only about 25 percent of area deaths in 2000 were part of hospice programs, and only 44 percent of end-stage cancer patients used hospice services.

The Role of Hospice

One of the largest changes in hospice as we know it came in the early 1980s when Medicare approved the use of hospice services as an optional benefit.

Hospice care goes back even further. Health Affairs described a shift in consciousness in the 1960s, changing from a movement to a philosophy. Many providers at that time expressed interest in being able to offer dying people more than just a quiet space and physical comfort to die. This approach included looking for ways to provide care along with emotional and mental comfort too.

The National Hospice and Palliative Care Organization said that the approach was championed by Dame Cicely Saunders in 1963 at Yale University. She was later invited to be part of the visiting faculty there and then created a hospice in the United Kingdom.

The approach received more appreciation and support from the medical community in 1969 with the release of “On Death and Dying,” a book where author Dr. Elisabeth Kubler-Ross discussed the five stages of grief and different attitudes that patients can have about their pending death.

As interest grew in the medical community, support and funding were also found in the political community.

For those interested in learning more about hospice services, Oct. 10 is World Hospice and Palliative Care Day, an opportunity to learn more about hospice services and get involved in promoting the value of hospice in your community and social media.