Hospice Care in America, from Life in the USA: The Complete Guide for Immigrants and Americans

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Life in the USA
Death in America
Hospice Care

Hospice Care
This material courtesy of Celeste Leibowitz

In medieval times, the word “hospice” meant a place of shelter and repose for tired or ill travelers embarked on long journeys. In America today, "hospice" refers to humane and compassionate care for terminally ill people and their families. It is based in the philosophy that even when a cure is no longer possible, hospice can offer palliative care to keep a patient safe and comfortable. Hospice can improve the person's quality of life on that final long journey.

The hospice movement originated in England in 1967, but quickly caught on in the U.S. through the work of Dr. Elizabeth Kubler-Ross, who wrote extensively about the process of dying and the needs of dying patients. In 1974, the first hospice in America was founded in New Haven, Connecticut. Today there are over 4,700 hospice programs in the United States.

Hospice care can take place in a number of settings. It is most often given in the home, but can also be offered in hospitals, nursing homes, and freestanding institutions. It recognizes that death is a normal part of the life cycle that will happen to all of us, and offers every person the care that is needed to die with dignity, peace, and comfort.

Hospice care does not postpone death nor does it hasten it, but aggressively treats pain and symptoms to afford the dying patient as much comfort as possible. Hospice is not about curing, but instead helps the patient and family attain a satisfactory measure of mental and spiritual readiness for death. After the patient dies, hospice offers bereavement support to the family members.

Hospice care is offered by an interdisciplinary team of caregivers: physicians, nurses, social workers, clergy, physical, speech, and occupational therapists, and friendly visits from a volunteer. By law, in the U.S., all hospices must use volunteers to provide companionship and caring in addition to the professional services offered, in order to maintain their status as Medicare providers. While the average hospice patient remains in hospice care for a little over 2 months, hospice organizations such as the Visiting Nurse Service of New York follow up with bereavement care for a full 13 months after the patient's death, if the family so desires.

The hospice movement has become increasingly popular in the United States as it offers a gentler alternative to the kind of aggressive care patients receive while still fighting for their lives. In 2007, 1.4 million patients received services from hospice. Today one in three dying persons in the U.S. chooses to take his or her final journey in the context of hospice care.

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