Op-Ed: The Reality of Hospice Care

There are many reasons people avoid talking about hospice care. Some people fear medical settings.
Some think it’s too expensive. Others don’t want to discuss–or face–their own death or that of a loved

One might think that the reality of an aging Baby Boom population might make the hospice conversation a central one for many families. More than 17% of people in New York State are over the age of 65.

Yet New York State has one of the country’s lowest hospice utilization rates. Only three out of every 10 people eligible for hospice care end up receiving it.

Whatever reason people may have for opting out of hospice, it's important to offer a clear idea about
what it is and the services it includes—when possible, it’s important to have information about these resources before they’re needed. And perhaps offering a more accurate picture of hospice may lead more people to be open to it as an end-of-life care option when other paths have been tried.

Hospice care can be affordable. Cost doesn’t have to be an obstacle to hospice care.  Although moving medical-grade equipment and medical services to a home or nursing home sounds expensive, about
30% of those who use hospice use Medicare.

Medicare covers those costs as part of hospice care. Three things need to be in place to make that

 A doctor must determine that the patient has six or fewer months to live and produce
documentation to that effect.
 The patient has to sign a statement choosing hospice care instead of other Medicare-covered
treatments for their terminal illness and related conditions.
 The patient is required to accept comfort/palliative care instead of medical care to cure their illness.

Although Medicare does not pay for room and board at home, or at a nursing home-type of facility, it does cover a wide range of services.

Hospice care is team care. It’s a tremendous collaboration among medical professionals that not only
addresses the needs of the patient, but the needs of the patient's family, caregivers and loved ones.
It can include services from doctors, nurses, aides/homemakers, physical and occupational therapists,
speech-language pathologists, social services, dietary counselors, grief and spiritual counselors and professionals who help manage symptoms and pain. Hospice services also can include inpatient respite

This group of professionals stays with the patient and their loved ones throughout the hospice experience, from initiation to bereavement. That can look like a grief counselor or social worker who offers guidance on how to help a child prepare for and heal from a loss, or it might be a spiritual or religious leader who’s sensitive to the patient’s background, needs and requests.

Hospice care is not about death. (In fact, patients who opt for hospice live longer than those whodon’t.) But it is about the quality of the end of a patient’s life.

It’s true that hospice care does not offer a cure. However, by providing professional support, comfortand peace for both the patient and their loved ones, it does offer something I hope we all value at theend of life: humanity.

Tara Liberman, DO is the executive director of Northwell Health’s Hospice Care Network and is an associate
professor of Medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health.

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