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Information from Your Family Doctor
Hospice Care in the Nursing Home
Am Fam Physician. 1998 Feb 1;57(3):497-498.
See related article on hospice care.
What is hospice care, and what are its purposes?
Hospice is the name for a special program of care for terminally ill (dying) patients and their families. Rather than trying to cure an illness, hospice efforts are directed toward making the patient comfortable, easing pain and other troublesome symptoms, and supporting the family through a sad time.
The hospice care program tries to provide the best quality of life for dying persons by providing a holistic approach—that means giving spiritual, mental, emotional and physical comfort to the patients, their families and their other caregivers.
What is a hospice team?
The hospice team is a group of dedicated professionals, support staff and volunteers who understand the special goals of hospice care. The team includes doctors, nurses, social workers, chaplains, aides and volunteers. The hospice team members focus their efforts on easing the symptoms of the terminally ill patient and providing support to the patient's family.
Is hospice care available to nursing home residents?
Yes. The services of hospice care programs are provided wherever patients are spending their final days, whether in their own home, in a family member's home or in a nursing home. The hospice team helps patients live out their final days with dignity and with as much physical comfort as possible.
The members of the hospice team try to help nursing home patients to be as free of pain as possible. They also try to help them be at peace with themselves and their illness. At the same time, the hospice team provides support, education and counseling to family members, nursing home staff and other nursing home residents who know the patient.
What specific services does a hospice program provide?
For the dying patient who lives in a nursing home, hospice care programs can provide the following services:
Nursing services above and beyond the usual nursing home care every day, around the clock.
Training of family members in patient care, as appropriate.
Spiritual and emotional support for both the patient and the family.
Help with practical matters associated with terminal illness.
Speech, occupational and physical therapies (when these services are considered useful by the hospice team).
Coordination of services and care with the patient's family doctor.
Through the Hospice Medicare Benefit, equipment and medicines (except a usual $5 copayment for each medicine) are paid for when they are ordered by the hospice team.
Bereavement and support groups for families.
Expert management of physical symptoms.
What is bereavement support?
Bereavement support is help in coping with the loss of a loved one. Grieving is a psychological process that nursing home staff members, family members and friends must go through when a person they love or take care of dies. It's necessary to feel the pain of grief in order to become whole again.
Normal grief has no timetable or calendar, and people experience grief in many different ways. Many people feel anger, loneliness, guilt, confusion and fear after a loved one dies. It helps to be able to talk about the person who has died.
Hospice is committed to helping people who are grieving. Hospice staff members and volunteers offer warm professional support to help family members with emotional healing and readjustment. Hospice respects the natural dying process and provides patients and family members with an opportunity for spiritual growth during this final phase of life.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1998 by the American Academy of Family Physicians.
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