Against The Stigmas of Death: Hospice Care

Updated: Jun 28, 2020

By Sungwon Cho

Graphic by Senching Hsia, Graphics Editor

We all know that if life begins, death inevitably comes. This is accepted as one of the most basic facts of nature, yet even if we try to live life to the fullest, we tend to hesitate to talk or even think about death. According to Dr. Block, a chair of the Department of Psychological Oncology and Palliative Care at Dana-Farber, the average time when the conversation about end-of-life wishes takes place is approximately one month before death, which is too late when you need to discuss all the issues related to end-of-life care with your family and set up funeral arrangements.

End-of-life (EOL) care planning is one potential solution to target the grim perspectives and lack of conversation surrounding death. EOL care is generally defined as health care not only for those nearing the final moments of their lives, but also for those with terminal conditions. Most EOL care plans are both extensive and helpful, as they allow one to choose with dignity the ways in which he or she will finish life. For instance, contrary to the assumption that the elderly hold negative attitudes toward death, one qualitative study that surveyed 30 Korean elders revealed that they were more than willing to discuss death openly with healthcare professionals in the interest of both preparing themselves for fear of death and helping their family members cope with the uncertainty and depression that follow death.

In order to spread the concept of a dignified departure, the government should better inform citizens about special systems for those approaching death, intended to enhance happiness and satisfaction at the end of one’s life. In particular, the hospice system, yielding a plethora of advantages compared to other such systems, should be strongly encouraged. Before we delve into its benefits, let’s first look at its key details.

What is hospice care?

Provided by an interdisciplinary team, hospice care guarantees expert medical care, symptom control, and emotional and spiritual support based on the patient’s needs and wishes. Hospice care is also provided to the patient’s family even after the patient’s death. The main goal of hospice care is not to cure diseases but to maximize patients’ satisfaction with their lives. Hospice services are accessible to patients of all backgrounds and terminal conditions.

What types of services are provided by hospice care?

Hospice teams are responsible for:

  • Managing patients’ pain and other symptoms of illness

  • Offering medication, medical supplies, and proper equipment

  • Providing bereavement support and counseling to the family of the patient

  • Providing the proper level of care depending on the development of disease in a patient

  • Delivering special services such as speech and physical therapy

Where is hospice care provided?

Most hospice care is provided at patients’ homes, nursing homes, or residential facilities, while other hospice services are provided in freestanding hospice facilities and hospitals. The locations of hospice care differ based on the types of medical care needed for patients’ specific issues.

What benefits do patients receive from hospice care?

To satisfy the clinical needs of a variety of hospice patients with differing stages of diseases, four different levels of hospice care are provided: Routine Home Care, General Inpatient Care, Continuous Home Care, and Inpatient Respite Care.

1. Routine Hospice Care (RHC):

  • Most common level of hospice care

  • Provided at the patient’s residence

2. General Inpatient Care (GIP):

  • To treat extreme pains or other acute symptoms of illness that are not easily cured in the other facilities

  • Offer nurses who are always available for direct patient care

  • Provided at Medicare certified hospitals, hospice inpatient facilities, or nursing facilities

3. Continuous Home Care (CHC):

  • To provide care for a terminally ill patient at his or her home in the case of pain or symptom inflammation

  • Provide hospice services for 8 to 24 hours a day

  • Offer intensive nursing care combining caregiver and hospice aide services

4. Inpatient Respite Care (IRC):

  • To provide temporary relief to the patient’s primary caregiver

  • Provided in a hospital, hospice facility, or a long term care facility

  • Offer sufficient 24-hour nursing personnel such as nurse assistants and home health aides

What benefits do families receive from hospice care?

Counseling or grief support for the patient and loved ones is an essential part of hospice care. After the patient’s death, bereavement support is offered to families at least one year. These services can take a variety of forms, including telephone calls, visits, written materials about grieving, and support groups. Individual counseling may be offered directly by the hospice, or the hospice may make a referral to a community resource. Some hospices also provide bereavement services to the community at large.

Are there cases of success?

Patient 1: Edith's Story (age 95, pancreatic cancer)

Edith’s dream to li