Hospice, Contemporary

Hospice refers to a facility where terminally ill individuals and their significant others receive care. But hospice as a philosophy refers to care provided by an interdisciplinary team of professionals and trained volunteers to a terminally ill patient and their loved ones when the patient has a life expectancy of six months or less and the focus of care is on comfort, pain control (palliative care), and quality of life, rather than on curing the illness. The National Hospice and Palliative Care Organization estimated that 1.3 million patients received hospice care in 2006. According to the Hospice Foundation of America, there are more than 3,200 hospice programs in the United States, Puerto Rico, and Guam. Hospice programs are also common in Canada and Europe, with programs becoming more common in other parts of the world, particularly Africa, Asia, Latin America, the Caribbean, and the Middle East. This entry will describe the hospice philosophy of care, eligibility criteria, the relevance of advance directives, the components of hospice care, and legal/ethical issues related to hospice care.

Hospice Philosophy

Hospice philosophy is based on the idea that dying is a normal part of the life cycle, that opportunities for growth are possible when nearing the end of life, and that the quality of an individual's life is more important than the duration of one's life following the diagnosis of an illness for which there is no cure. Hospice views the patient and family as the unit of care and promotes patient self-determination, with patients and their families participating actively in the care planning process. Efforts to achieve a high quality of life stress the importance of physical, emotional, and spiritual comfort, the preservation of one's dignity while dying, and the ability to live one's final months and days in the least restrictive environment possible. Ideally, hospice care is provided in an individual's home, with friends and family providing care with the support of hospice professionals and trained volunteers. If this is not possible, hospice care may be provided in a specialized hospice facility, a hospital, or a skilled nursing facility. Hospice care has also been provided in hospice programs within prisons.

Components of Hospice Care