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Hospice, a type of palliative care, is the model for quality, compassionate care for people facing a life-limiting illness or injury. Hospice and palliative care involve an interdisciplinary team-oriented approach to expert medical and nursing care, pain and other symptom management, and emotional and spiritual support expressly tailored to the patient’s unique needs and wishes. Another special difference is that support is provided to the patient’s loved ones as well. At the center of hospice and palliative care is the belief that each person has the right to die with dignity and in comfort. Families receive the necessary support to allow that to happen (American Cancer Society, 2019). The patient, family, and caregivers are the unit of care, not solely the patient. This is a very different and special construct seen primarily in hospice and palliative care.
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CMS, the largest payer for hospice, defines hospice care as “a comprehensive set of services identified and coordinated by an interdisciplinary group (IDG) to provide for the physical, psychosocial, spiritual, and emotional needs of a terminally ill patient and/or family members, as delineated in a specific patient plan of care” (CMS, 2008, p. 18).
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The hospice philosophy of care asserts the concept of palliative care, which promotes quality of life by enhancing comfort for individuals and their families, whom hospice considers the unit of care. Hospice focuses on care versus cure. When cure is no longer an option, hospice recognizes and provides support for a comfortable death with dignity as a fundamental goal of care. The hospice philosophy also recognizes that death is a part of the life cycle. The provision of comprehensive palliative care addresses pain relief and comfort and enhances quality of life for the terminally ill. The hospice team assesses the needs of the individual and the individual’s family in the last phase of life and works with them collectively to develop a care approach that encompasses physical, emotional, spiritual, and cultural concerns and wishes of the individual and the individual’s family. Hospice provides palliative care to all individuals regardless of age, gender, cultural background, beliefs, diagnosis, availability of a caregiver, socioeconomic status, or ability to pay. Care is generally provided in the late stages of an advanced illness, during the dying process, and continues in the bereavement period.
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The word hospice can be traced back to the medieval era, when it referred to a place of rest or shelter for tired or ill travelers who were on a long journey. Dame Cicely Saunders applied this term to her work with terminally ill patients in 1948 with her specialized approach to caring for the dying. Saunders developed the total pain theory to address the entirety of suffering (physical, spiritual, psychological, and social) for patients with advanced illness and at the end of life. Addressing a patient’s pain in this holistic ...