A study showed an example of 91-year-old father returned from the hospital after a bout of pneumonia and was readmitted scarcely a week later, his doctor suggested that hospice care was probably a good idea. He was extremely frail and barely able to walk. His overall health wasn’t improving.

Like most people eyeing hospice care as the end stage of medical intervention, I was reluctant to make that decision. It’s one of the most difficult health care decisions you’ll make because of hospice's astounding recognition of mortality.

How Hospice Works

Medicare pays for hospice care for people who are terminally ill, “with a life expectancy of six months or less, if the illness has run its normal course. While that definition sounds muddled many could live for only a few days or several years it’s a different philosophy of care. It’s rare that hospice patients survive for half a year. The average hospice from 2011 through 2016 was 71 days or about 2 1/2 months.

Illness

Medicare defines hospice care as a “specially trained team of professionals and caregivers providing care for the ‘whole person,’ including physical, emotional, social and spiritual needs.” At the core of hospice is palliative care making the patient feel as comfortable as possible and not directly treating an illness

A Misunderstood Option

The major difference between hospice care and conventional treatment is no longer isolating and treating specific causes of health issues. “The biggest myth of hospice care is that you have to relinquish all treatments. They are only relinquishing ‘further extreme measures’ such as another course of chemotherapy.

While hospice care can be offered in facilities, it’s generally given in the home and includes counseling, drugs and equipment like hospital beds. There’s also support and counseling for the family.

Terminally Ill

But the biggest barrier with hospice isn’t its end-of-life focus, it’s the fact that most patients and families choose it too late, says Finkelstein. Relieving pain — the centerpiece of palliative care should be considered earlier rather than later in the process. And you don’t have to be terminally ill to receive it.

The time for palliative care is anytime. Look at the situation from the patient’s and family’s point of view. Anytime something serious is happening [with pain management].

Making the Decision

No heroic medical measures would be offered, though, which is hard for most families to accept. The hospice providers were trying to make my father feel as comfortable as possible and add a measure of peace to his life, which had been marked by a series of diagnostics for maladies that couldn’t be cured under ordinary means. 

It’s Never Easy

The decision to enter into hospice care is painful.Try to get everyone on the same page. Evaluate the prospects of a loved one getting better with conventional treatments compared to the suffering that extensive medical care will entail.

Medications

Sit down with a hospice provider, who can be recommended by a doctor, hospital or long-term care facility, and ask how the provider would respond to specific situations. If you’re searching for a hospice provider on your own, you can obtain a referral from Medicare. In some cases, hospices were not able to effectively manage symptoms or medications, leaving beneficiaries in unnecessary pain for many days.

Hospice 

Hospice is less about what we think modern medicine should do and more about finding a small sense of serenity in one’s final moments. It may be little consolation to most families, but it’s a more compassionate approach that can strive to ease suffering.