What is Hospice Care?

By John Washburn, Sr.

What, exactly, is hospice care? As a Community Liaison for Community Hospice of Texas located in Dallas, Texas, I get asked this question on a daily basis. And the answer is really quite simple. Hospice care is end-of-life care. Easy enough, right? Well, it is a little more complicated than that, so let me explain. Many people think that hospice, somehow, shortens life. Well, every study regarding this subject in the last 10 years has shown that hospice care not only does not shorten life, it actually extends life anywhere from 29 to 89 days! Hospice is not about dying, which is a commonly held misconception. Hospice is about living. It’s living everyday, from this day to your last, as fully as possible. It is about having and accomplishing goals. Goals that one sets and wishes to accomplish before time runs out. Hospice helps individuals accomplish those goals.

So how does someone qualify for Hospice care? The first thing is that you must have a C.O.T. (certificate of terminality). This is where a physician, based on his experience and best judgement states that you have six months or less to live provided the disease state follows its normal course. So, you say, hah see, it is about dying. No, because, one thing hospice never does, we never take HOPE off the table.

The God I know, love and serve is still a God of miracles. And, He can perform one any time He gets good and ready. I’ve seen it more times than I can count. Miracles happen everyday.

But we are realistic in Hospice, we know that we must deal with the facts of the disease process. Yes, God can intervene at any time but lets face it, we are all going to die. As sure as you drew your first breath, the day will come when you will draw your last. That’s why hospice is here. Hospice helps families deal with this reality. In fact, we have programs for families for up to 13 months after the loved one passes. Hospice has bereavement services, grief counseling and access to a Chaplin if needed. Here is perhaps the most commonly held misconception about Hospice. People think it is round-the-clock nursing care. It is not. Also, it is not custodial care. It is intermittent, skilled nursing care. It is VERY IMPORTANT to understand this.

Now, let me take a moment to explain the levels of hospice care. There are four of them.

ROUTINE CARE – this were the care is provided wherever the patient calls home. This can be their private residence, assisted living, skilled nursing facility, again wherever the patient calls home.

RESPITE CARE —this is designed to give the primary care giver a break, to rest or take care of personal matters. It is provided at an inpatient facility and limited to 5 days but can be done as often as monthly.

CONTINIOUS CARE – also known as crisis care. A hospice representative stays with the patient until the crisis is resolved….and then they leave. And, no, actively dying does not necessarily qualify for continuous care.

INPATIENT CARE – this is round the clock care usually provided at an inpatient facility. Not all hospices have inpatient facilities and if they don’t, this care can be given at the hospital. Before signing with any hospice, be sure and check to see if they have an inpatient facility.

Approximately 90% of patients are admitted to Routine Care. But, a patient can be admitted into any level of care.

So, what does all this cost? Hospice is paid for by Medicare, Medicaid and most private insurance companies with little or no charge to the patient. I believe, this makes Hospice the best value in healthcare today! No co-pays or deductibles for nursing care, medications and medical equipment is a huge help to most families.

I’ll finish with this, and it is sad. The hospice benefit is a minimum 6 month benefit yet, the average stay on hospice in America today, is just 11 days! In fact, the one thing we hear most in our post need surveys is: I wish I had known about Hospice sooner! I told you it was sad.


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