Charting Your Course : Seminar II - Navigation Aids : Hospice

The Hospice movement has specialized for over twenty years in the many issues we all face as we consider the end of life. Hospice offers special medical care and support to those on the final journey of life. The resources of your local Hospice agency might be a great support to you and your family. Hospice nursing staff and volunteers will be available to support you in making your final months, weeks, and days together a time of comfort, of resolution, and of peace.

Hospice Services are available to you at home, in the hospital or in nursing homes. The Hospice mission is to respect and to respond to your interests and needs during this special and often stressful times. You can find your local Hospice office in the phone book.

Hospice offers a team approach to supporting you and your family. The staff works closely with you, your family and your doctor to meet your wishes and needs. You decide which services might be useful. You can let Hospice know what you want from staff or volunteers. You will decide what you want to do and what you want others to do. Hospice will support you in your decision-making and will respond as best it can. Here are ways in which Hospice might be useful to you:

In your home - If you wish to live at home through the end of life, Hospice nursing staff, in close communication with your physician, will offer the highest standard of pain and symptom management. A social worker, counselor or therapist might offer valuable emotional support to you and your family. The Hospice chaplain may be a resource to you and/or to the clergyperson to whom you turn for spiritual insight and support.

For some families, it is the trained Hospice volunteer who is most helpful in the home. Volunteers might run errands, do cores, drive, read aloud, play with children, listen to stories or just be a quiet and supportive presence.

For patients who wish to be at home, Hospice staff and volunteers are often able to provide the assistance and support which make that possible. Many of these services may also be provided if you are living in a nursing home or retirement facility.

In the hospital - In a hospital, your medical needs will be taken care of by hospital staff with Hospice specialists as an additional resource. You might like to have Hospice volunteers go outside with you for a ride, for a walk, or just for fresh air. You might enjoy a visit when family and friends are not available. There may be times when you would just like to have someone with you, with no need to talk.

Volunteers might read with you, write letters, make phone calls, run errands or bring a favorite snack. They might also support family members with driving, conversation, child care, chores or meal preparation.

Bereavement - There will be grief for your loved ones after your death, and it is important that they find ways to experience and express that grief. Hospice offers a variety of bereavement support opportunities. Hospice offers skilled and experienced counselors to meet with your family members and friends; many hospice volunteers are also trained and experienced in grief work. Most Hospice groups sponsor bereavement groups for children, for widows and widowers, for adults grieving the loss of a parent and for others who are dealing with loss. Often, a Hospice Memorial Service provides an additional opportunity to share grief with others who will understand. Hospice libraries may also be a resource as you anticipate and experience the pain of loss.

The Hospice commitment is to keep in touch with loved ones for at lest a year following a death. Staff will do all they can, if families wish, to support them in sharing their grief and in healing through their experience of that grief.

Library - Hospice libraries are available for all residents of most Hospice areas. Many people find that videotapes, books, magazines and articles dealing with issues of life and death can contribute to easing the stress of looking ahead to death and inspire them to live this time more fully together.

Community Education - Throughout many service areas, Hospice sponsors lectures, workshops and training sessions to help people understand not only that death lies ahead of every one of us, but that we can have many choices in how we live until we die.

Hospice nationwide encourages everyone to open to the inevitability of death in some form and at some time; to talk with family and friends about our wishes and theirs around end of life choices; to complete Advance Directives while we are healthy; and to become aware of Hospice services which might be useful to family or friends. Call your local Hospice for education opportunities.

Almost all costs of Hospice services are reimbursed through Medicare, Medicaid, CHAMPUS, or other insurance programs. For most services there is no direct cost to the patient or family. When there is a charge, Hospice staff will work with patients and families and sliding fee scales to be sure that the fee is not an unreasonable burden. You may ask your doctor or hospital staff to contact Hospice to arrange an introductory visit at the hospital or when you go home. You or a family member or friend are also welcome to call your local Hospice directly to request services or further information.

Some questions to consider:

When might I, or my family, need to contact this program?
How do we connect to a Hospice program?
Who can assist us?

Some things to do:

Ask about Hospice and what local plans are available in your community
Speak with others who have used the program
Speak with your family

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This content is derived from the "Charting Your Course Seminars: A Whole Person Approach To Living With Cancer", provided by Norris Cotton Cancer Center.