I was able to spend several years as a hospice chaplain before entering my current role as a hospice bereavement counselor. I am a bereavement counselor for a hospice. Most of the people I speak with have lost loved ones who used our hospice services. And even after all of that, many people are still unsure of what “Hospice” is and is not.

Hospice is philosophy of care for end of life.

Despite the common misperception, hospice is not a specific company. Hospice is a philosophy of care for end of life. The Banner Hospice website says:

“Hospice is a philosophy of care that provides specialized health care for people nearing the end of their life. If you have a terminal illness or, have decided not to pursue further curative care, and want to focus on comfort and quality of life, hospice care may be right for you. Banner Hospice provides symptom management with a focus on dignity, as well as support services for you and your family.”

The term “hospice” stems back to medieval times when it described a place of shelter and rest for weary or sick travelers on long journeys. Along the way, the term came to refer to humane and compassionate care given to people in the final phases of a terminal illness (given in a variety of settings; homes; hospitals; care facilities).

In 1967, Dr. Cicely Saunders founded St. Christopher’s Hospice in England; the first of its kind specifically to focus attention on the care of terminally ill persons and their families. Among the first staff at St. Christopher’s was an American nurse named Florence Wald, who brought Saunders’ philosophies back to the United States to become the founder of the hospice movement in the United States.

In 1971 Robert Twycross was appointed as a Clinical Research Fellow by Saunders. During his tenure there, his studies on the effectiveness of morphine, diamorphine and methadone helped standardize and simplify the management of cancer pain.

The hospice movement gained momentum in the United States through the work of Elisabeth Kübler-Ross and the founding of the first Hospice Home Care Program on New Haven, CT in 1974.

In 1986, Congress made permanent the Medicare Hospice Benefit and the various States were allowed to decide whether they wanted to include hospice in their Medicaid programs. According to the latest statistics available from the Hospice Association of America and the National Hospice and Palliative Care Organization: More than 5,300 hospices participate in the Medicare program in the U.S.

Hospice is a philosophy of caring for dying patients and their families that recognizes that death is a part of the life cycle and that every person has the right to die with dignity, peace, and comfort. Hospice is a “not a place; it is a concept of care for those who have life-terminating illnesses. Even if medicine cannot provide a cure, hospice can offer comfort, care, and assistance, to help maintain quality of life, even if we can’t lengthen quantity of days. Hospice affirms life and neither postpones nor hastens death; (though treatment for the primary diagnosis does stop) it exists so that patients and their families might be free to attain a measure of mental and spiritual readiness for death that is satisfactory to them.

If that’s hospice, what is palliative care?

Palliative care is an interdisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. It focuses on providing relief from the symptoms, pain, physical stress, and mental stress at any stage of illness.

All hospice care is palliative care but not all palliative care is hospice care.

“Palliative care” can begin at diagnosis, and/or at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness. In other words, there must be a terminal diagnosis for hospice care to begin. Hospice care includes elements of palliative care but its design is to allow the dying process to be as comfortable as possible.

Hospice is end-of-life care for your loved one.

I am privileged to work in Hospice. I get to walk alongside families during what is perhaps the most difficult time of their lives. It is something I believe in deeply and wish more people understood and embraced.