Hospice: Dying With Comfort, Dignity, and Grace

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November is National Hospice and Palliative Care Month.

Hospice. This modern word has its root in the Latin word hospitium, which means “guesthouse.” It calls to mind a place of shelter for weary travelers seeking rest during a pilgrimage or long journey.

Dame Cicely Saunders, a British physician, started the movement we know as hospice care. What started in England spread to America and then across the globe.

November is National Hospice and Palliative Care Month in the United States. Here is an overview of hospice -- the movement, the concept, and the impact it has on families around the world.

Hospice: The Movement

Saunders began the movement in 1967 with the opening of St. Christopher’s Hospice near London. The program established a team-oriented approach to professional caregiving for terminally ill patients.

St. Christopher's Hospice was the first program to use modern pain management techniques to provide compassionate end-of-life care.

Although the hospice movement initially met with resistance, it eventually spread through England and the United States. The first American hospice was founded in 1974 in New Haven, Connecticut.

The late 1980s saw a handful of institutions provide hospital-based palliative care programs. Today, nearly 5,800 hospice programs exist in the United States -- including Hospice Brazos Valley, whose health care team provided compassionate care for my dad during his final weeks of life.

An estimated 1.5 to 1.6 million patients received hospice care in 2014. Hospice has grown from a small, volunteer-led movement to a significant part of the American health care system. Medicare, Medicaid, and most private insurance plans now cover hospice and palliative care services.

Hospice: The Concept

While some inpatient facilities provide palliative care, hospice is not a place. Rather, it is a concept of care.

According to the Hospice Foundation of America (HFA), 80 percent of hospice care is provided in the patient’s home, a family member’s home, or a nursing home.

Hospice uses a team approach to medical care, pain management, emotional and spiritual support. Care is tailored to a patient’s needs and wishes. The National Hospice and Palliative Care Organization (NHPCO) calls hospice “the model for quality, compassionate care for people facing a life-limiting illness or injury.”

Hospice focuses on the belief that each person has the right to die pain-free with dignity and grace. It centers on caring, not curing. Hospice is designed to provide comfort and support to patients and their families.

“You matter because you are you, and you matter to the end of your life,” was Saunders’ philosophy. “We will do all we can not only to help you die peacefully, but also to live until you die.”

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Hospice: The Impact

Hospice care begins when a terminal illness no longer responds to cure-oriented treatment. It is meant for a time when treatment can no longer help, and the patient is expected to live less than six months.

Hospice provides around-the-clock care for the dying patient. Although it addresses all symptoms of a disease or injury, it focuses on pain management.

Hospice addresses the emotional, spiritual, and social impact of illness on a terminally ill patient and their loved ones. It also provides family counseling services and bereavement support after the patient’s death.

Hospice neither hastens nor postpones death. Rather, it affirms life. The goal of hospice care is to improve the quality of a patient’s last days by treating the person instead of the illness.

“We should learn not only how to free patients from pain and distress, how to understand them and never let them down…” said Saunders, “but also how to be silent, how to listen, and how to just be there.”

Your Turn

Do YOU have experience with hospice care? Tell us about it in the comments below. And if you liked this post, use those nifty buttons on the left to share it with your social networks. Thank you!

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© 2013 Annette R. Smith

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Comments 20 comments

patricia_bruce profile image

patricia_bruce 3 years ago from Wisconsin

What a beautiful hub.

We had to put my father in a hospice and it was a heart-wrenching thing for us to have to do, knowing the outcome.

Once there, my father came back to life. Off all his many meds, we were able to enjoy and celebrate life with him for an amazing 12 days. I was so touched and humbled by the caring and wonderful staff at my dad's final home, AngelsGrace.

I was able to live in the moment with my dad, not focusing on his death, but happy to enjoy every last moment of his life. Quality time and touching memories made while there were such amazing gifts we never thought we'd have.

Thank you for writing about this very important part of what may become part of our lives, and how to embrace it.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

Hi, Patricia! Thank you for reading my article, and for telling us about your experiences with hospice. I am so sorry for your loss, but I'm glad to know that your father received such compassionate care during his final weeks.

My father had Alzheimer's disease, and he spent his last year in and out of the hospital for pneumonia. He received hospice services at the hospital during his final days.

Because of the wonderful people at Hospice Brazos Valley, we were able to spend that time together as a family -- sharing our love and making memories. It's something I will always cherish.


patricia_bruce profile image

patricia_bruce 3 years ago from Wisconsin

Hi Annette - I'm so sorry for your loss, too. I feel the same way...will always cherish those final days filled with love. I'm glad you were able to experience some light in a very dark period in your life.


MsDora profile image

MsDora 3 years ago from The Caribbean

Dame Cicely Saunders has made the world a better place for those who are dying a well as those close to them. I have not had any hospice experience but from listening to those who have, and also from reading your article, it sounds like compassion as its highest. Thank you for the history and other information.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

Thank you, Patricia.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

You're welcome, MsDora. Compassion is a good definition of hospice, and hospice services can make a difficult time so much easier for those who are dying as well as their families. I'm so glad you stopped by!


tebo profile image

tebo 3 years ago from New Zealand

Hi Annette. I work at our local hospice as a Health Care Assistant on night shift alongside a registered nurse. I really like my work, helping to make the patients time with us as comfortable as possible for them. What a lovely way you have explained how hospice care works. Well done.


Phyllis Bonner 3 years ago

My husband died on August 9th. He had Parkinson's Disease. I was his caregiver. The last 3 years were the hardest. I had made him a promise that I would do everything in my power to keep him out of a nursing home. And I would see that he got to spend his last hours at home. We had a wonderful Hospice Company that helped us . If it had not been for them I certainly would not have made it through. That last week he lived was the hardest week of my life. Standing by his bed and watching him die for a whole week made me feel so helpless!!! I don't think I will ever get over it!!! I'm thankful to my God for the strength he gave me, and for the wonderful Hospice team He brought into our lives.


denise.w.anderson profile image

denise.w.anderson 3 years ago from Bismarck, North Dakota

It is good to know about this service. Does a patient have to be referred for Hospice care, or can a person call themselves to get the services?


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

It's a pleasure to meet you, tebo. Thank you for your thoughtful comment. And thank you for the wonderful work you do for your patients and their loved ones. Your compassionate care is appreciated more than you know!


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

I am so sorry for your loss, Phyllis. Praise God for giving you the strength and grace to care for your husband during his illness, and for sending you such a wonderful hospice team to help you during this difficult time. My thoughts and prayers are with you this afternoon.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

Hi, Denise. Thank you for your question. The way I understand it, hospice care usually begins with a discussion with the patient's doctor. This is the way my family received hospice care for my dad. However, I think anyone can call to make a referral or inquire about hospice services: a doctor or other health professional, nursing home or assisted living staff, or family members.


Alastar Packer profile image

Alastar Packer 3 years ago from North Carolina

Hospice does affirm life, so true. Thank you for writing on this, Annette. Hospice is one thing we have gotten right in a world that sometimes seems insane. A wonderful lady just passed from terminal cancer in my neighborhood. She choose friends, a loving recent husband, and son, to be with her in the final months. Her faithful old dog "Trouble" died next to her several days before she herself did. Her last words with a beatific look on her face were, "No regrets."


teaches12345 profile image

teaches12345 3 years ago

Hospice is a wonderful solution for many families as they have to say good-bye to a loved one. It is also a place of comfort and rest for those who need the respite. WE just had a friend's father in hospice; however, he recovered and was able to go back home. The people there are excellent at helping families cope and to get through the pain of illness and death.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

You're welcome, Alastar. Thank YOU for reading this. How wonderful to hear of your neighbor's peaceful last months with her family and Trouble, her beloved dog. Thank so much for sharing this with us.


Annette R. Smith profile image

Annette R. Smith 3 years ago from Orlando, Florida Author

It really is, Dianna. Hospice workers are wonderful, compassionate people, but I'm sure that their work takes a toll on them, as it does for any caregiver. They certainly have my gratitude and prayers. I'm glad to hear that your friend's father recovered and is now back at home.


Sam-Wright profile image

Sam-Wright 2 years ago from Albany, New York

The best thing about hospice is that it also works with the surviving loved ones. It's hard to lose a loved one and those left behind will need all the comfort and assistance that can help them go through the grieving process. I do agree that providing hospice care is also showing compassion. For me, this type of care is more personal because you're bringing comfort, self-worth and serenity to patients who are living the final months or years of their lives.


Annette R. Smith profile image

Annette R. Smith 2 years ago from Orlando, Florida Author

Hello, Samantha. Thank you for reading my article and sharing your thoughtful comment. I can't say enough good things about Hospice Brazos Valley. As well as comforting my father during his final days, they provided comfort and support for my family during a very difficult time.


Larry Rankin profile image

Larry Rankin 17 months ago from Oklahoma

Hospice work is very important and difficult work. I have a great deal of respect for people in that field who are sincere and do their work well.


Annette R. Smith profile image

Annette R. Smith 17 months ago from Orlando, Florida Author

Hi, Larry. It's a pleasure to meet you! Hospice is hard work, indeed -- but very important for patients and their families. I have tremendous respect for hospice workers, too. Thank you for your comment.

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    Annette R. Smith498 Followers
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    Smith is a content writer in Orlando, Florida. She writes web content for HubPages, Savoring Home, and other blogs and websites.



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