Perspectives: Use of hospice care has increased

Hospice care is not a new idea, but it's been growing in recent years.

The Ohio State University Medical Center reports more than 3,200 hospices across the U.S. currently participate in Medicare, representing a 100-fold increase in those facilities between 1984 and 2008. In addition there are another 200 volunteer hospice programs in the nation.

"Our goal is to increase the quality of life as much as possible for our patients and their families," said Becky Dotson, director of Amedysis Hospice of Parkersburg.

"The idea of hospice care has been around for centuries, and it really came to light in the U.S. in the 1960s," she said. "But in the 1980s, hospice became prevalent as a means of end-of-life care for cancer patients."

Currently only about 60 percent of those receiving hospice services across the country have been diagnosed with cancer.

Dotson said hospice care also can include dementia patients as well as end-stage heart and end-stage lung patients.

"We're looking at a broad spectrum of people," she said. "These are patients who have no further treatment options, or those who decide they don't want to pursue any more options and don't want to go back into a hospital environment because they believe they're just wasting what precious time they have left."

Dotson leads a hospice team that includes physicians, nurses, patient aides and volunteers, chaplains and medical social workers - all focused on making those precious last days comfortable for both patient and family, who are also considered part of the team.

Dotson said one challenge for all hospice programs is educating the public about the advantages of end-of-life care.

"We've spent the last 18 months trying to educate people about the benefits of hospice care, and I've made that my mission," she said. "We'll take any opportunity we can to talk with church groups, pastors, civic organizations and other groups about hospice. And questions about the program are always welcome at any time."

Marietta resident Bill Standish said hospice care was a big help back in 2005 when he and his brother lost both of their parents, Omer and Wilma Standish, to terminal illnesses.

"My dad had some help from hospice before he died from COPD (chronic obstructive pulmonary disease) in July," Bill Standish said. "His care was mostly assistance with breathing and bathing.

"Mom had cancer. She wanted to take care of dad, and we let her do that for as long as she could, but close to three months after he died, her body just started to give out," he said.

Standish learned about the availability of hospice care through a friend.

"My brother and I were the only ones to take care of dad and mom, and hospice made it so much easier for us," he said. "Mom didn't want to go into a nursing home, so our main goal was to keep her at home. She was able to stay home until she died in December."

Standish said the hospice team was always there to take care of his mother's needs.

"But they didn't take over our lives, they did exactly what we needed them to do, and it was nice to have someone who could check in on mom or help keep her medications straight," he added. "It also freed up time to run errands and pay bills. And we could call hospice at any time."

The family was always kept abreast of the dying process, too, Standish said.

"(Hospice) told us what we should watch for," he said. "They were there to care for her until the end, and helped maintain her dignity.

"I think of mom every day," Standish added.

Memorial Health Foundation director Wendy Wharff said Standish is one of the loyal donors to the foundation's annual Love Lights program at Christmas, when charitable gifts are made in memory of loved ones to benefit Memorial's hospice program.

"Hospice provides a whole range of services, not just medical care, but also bereavement and counseling services for patients and families," Wharff said. "I think that's why people are so passionate about giving to Love Lights during the holidays. We send letters to hundreds of donors every year. Last year the letters were a little late and we had people calling us, asking if we had forgotten them."

She said the program took in more than $20,000 in 2010.

"But we take donations for the hospice program all year," Wharff said. "Contributors can simply designate 'hospice care' on their checks. It's a great way to remember your loved ones."

A portion of the money raised by Love Lights is used to help cover medical costs, that are not covered by insurance, for terminally ill patients. Money can also be used in other ways to lift spirits in difficult times, such as providing a way for a family member to come and visit a dying relative, officials have said.

A recent report from the Hospice Association of America listed some Medicare hospice rates that were effective as of October 2010. The report noted that rates often vary according to the level of care received:

Routine Home Care Day: $146.63. This category is for individuals receiving hospice care at home. The rate does not vary by volume or intensity of services.

Continuous Home Care Day: $855.79 for 24 hours, or $35.66 per hour. Individuals in this category must need services for a period of at least eight hours within a 24-hour period, but only for brief periods of crisis and only as necessary to maintain the terminally ill individual at home.

Inpatient Respite Care Day: $151.67. Care may be provided for no more than five days at a time in an inpatient facility.

General Inpatient Care Day: $652.27. Care may be provided in a Medicare-certified hospital, skilled nursing facility, or inpatient unit.