As a Strategic Account Manager for Hospice & Palliative Care Charlotte Region I like to start many of my educational in-services and community events with a question: “What do you think of when you hear the word ‘hospice’?” As you can imagine, depending on the crowd I receive a multitude of answers to that question. Based on these answers I wanted to share some of the most common hospice myths and misconceptions that our staff must overcome when educating the Charlotte community about end of life care.
Myth: Hospice is a place that caters to the terminally ill before they die.
Fact: Established in the United States in 1974, hospice is a concept of care that focuses on intense-symptom management for patients with life-limiting illnesses. The majority of that care is provided in whatever setting is best for the patient and family. The care may be in their private residence, a loved one’s home, a senior living community or a specialized Inpatient Hospice House, allowing patients to live the final days in comfort and security while being cared for by an expert, compassionate medical team. Hospice does not have to be a destination but it may be helpful to ask a hospice organization if they do have an Inpatient Hospice House that your loved one can utilize if they cannot be well managed at home.
Myth: Hospice care is only eligible in the final days of life.
Fact: A patient is appropriate for hospice care when they receive a terminal prognosis of 6 months or less when their disease takes its natural course. If a patient is in hospice for longer than 6 months a determination has to be made to recertify the care by determining if the patient continues to meet the criteria for care. If it is determined a patient is no longer eligible for care, the patient is discharged from hospice services; however, those services can be picked up again as needed.
Myth: The physician decides whether a patient can receive hospice care and through which organization a patient should receive that care.
Fact: Patients have a choice when they are faced with a life-limiting terminal illness. A physician’s role is to offer recommendations for care, and hospice care can be a part of that recommendation. While physicians may offer a referral for care, it is ultimately the patients’ decision on where they receive care and who they receive it from, making patient education incredibly important so that they choose the hospice that is best aligned with their care goals.
Myth: If I choose hospice I have to give up my primary care physician.
Fact: A hospice care team relies on the patient history and expertise of the primary care physician and works closely with the physician to ensure the patients’ needs are being met.
Myth: Hospice care is for patients who have received a terminal cancer diagnosis.
Fact: Only about 27% of patients in hospice care have cancer, while dementia, alzheimer’s, congestive heart failure, and respiratory diseases are rising as primary reasons for a hospice referral.
Myth: I have to sign a Do Not Resuscitate (DNR) order before I can receive hospice care
Fact: The patient can receive hospice care without signing a DNR. The hospice regulation actually says that hospices cannot discriminate against patients because of their advance directive choices.
Myth: Hospice care is expensive if you are not eligible for Medicare.
Fact: If a patient is under the age of 65 and not eligible for the Medicare or Medicaid benefit, insurance coverage is available through many private insurance plans. In addition, many not-for-profit hospices cover all patients regardless of their ability to pay.
Myth: Choosing hospice is giving up on life
Fact: Hospice is a holistic care that addresses the spiritual, emotional and medical needs of the patient and their families. Hospice allows patients to focus not on the life they have left, but on making the most of the life that remains. At its’ center, hospice care is about life, not about death.