Hospice, an approach to palliation, provides care to terminally-ill patients who are in the final stage of their lives, and often patients in the progressive stages of a life-threatening illness. The goal of hospice care is to maintain the highest quality of life attainable, by enabling the patient to live as comfortably and as pain free as possible, preferably in the comfort of home. The goal is to control symptoms, not to cure the disease.

The hospice philosophy is holistic, family centered, and home centered. Hospice focuses on the person, not the illness. It treats the family, not the individual. It is a cost-effective alternative to institutional care. Hospice aims to maximize the quality of life, not the duration of life.

Hospice provides an individualized care plan for each patient and family. It is designed and managed by a multidisciplinary health care team. The team consists of a physician, a registered nurse, home care aides, social workers, counselors, and volunteers. They provide social, emotional, spiritual, and psychological support, as well as medical care. Care is provided in the home, except in special circumstances, where in-patient care may be necessary on a temporary basis.

Who is Eligible to Receive Hospice?

All terminally ill patients in the final stages of life, and often patients in the progressive stages of a life-threatening illness, can receive hospice care. This includes people of all ages, including children, and the insured and uninsured. Medicare, Medicaid, and most private insurance companies and health management organizations cover hospice costs. Patients must contact their insurance providers to determine exact coverage. Many hospice providers accept all patients without regard to their ability to pay. Contact the hospice providers directly for more information. Click here for more information on insurance coverage of hospice care (including information on local insurance companies, Medicare, and Rhode Island state plans such as Medicaid and RIte Care.

Patients and families in need of hospice care should contact local hospice providers as soon as possible to learn about the availability of services and coverage for them. For suggested questions to ask hospice providers and for a list of hospice care providers in Rhode Island, please follow the link for hospice care providers.

Services Typically Provided by Hospice:

Hospice services are usually provided in the home. This is called out-patient care. In-patient care, given by a participating hospital, nursing facility, or hospice facility, is used only when absolutely necessary.

Hospice care is provided by a team. A description of the roles of typical team members is given below, as well as additional information on other services that may be available. Each hospice differs in the way it provides services to patients and families, including the way in which it assembles service teams.

Registered Nurse

Coordinates team care for patients
Provides direct patient nursing care
Provides patient and family education

Social Worker

Provides advice and counseling to both patient and family
Works with team with understanding of family dynamics
Accesses community resources

Physician

Provides physician care
Approves team health care plan for patient and family

Home Care Aide

Provides assistance with personal hygiene, such as bathing, shampooing, shaving, nail care

Homemaker

Provides light housekeeping and meal preparation

Volunteer

Provides emotional support
May offer services such as shopping, babysitting, and car pooling
If you are interested in volunteering with a hospice provider, click here to find a hospice near you.

Physical, Occupational, and Speech Therapies

Help patients develop new ways to conduct everyday tasks that may have become difficult, such as walking, dressing, bathing, or feeding oneself

Religious/Spiritual Counselor

Clergy and other spiritual counselors are made available at the patient's request.

Continuous Care in the Home

Under special circumstances nursing care may be provided in the home from eight to 24 hours per day.

24-hour on-call Availability

A member of the team is on call and available 24 hours a day, seven days a week.

Respite Care

The patient may be temporarily put into care of an in-patient facility to provide relief for family members.

Medical Appliances and Supplies

Necessary medical appliances and supplies may be made available to the patient and family, including drugs and biologicals.

Bereavement Support

A team member works with the family to deal with the loss of a loved one and the process of grieving.
Bereavement programs are often open to anyone who has experienced a loss, regardless of their use of hospice care.

Helpful Links For More Information on Hospice Care

Aging 2000: A Rhode Island Consumer Organization Dedicated to Improving the Health Care System for Seniors www.aging2k.org
A family guide to end-of-life care. Provides information and access to local resources.

Growth House, Inc. www.growthhouse.org
Wide range of information on hospice and palliative care, life-threatening illnesses, planning and decision making, and bereavement. Provides related website links.

Hospice Association of Americawww.hospice-america.org
Fact sheets about hospice, hospice services, getting services, paying for services, and benefit coverage.

Hospice Net www.hospicenet.org
Basic information regarding hospice care, patient issues (ex., pain, advance directives, palliative care, and death and dying), caregiver issues (ex., support, decisions, saying goodbye), and bereavement.

Hospice of North Central Florida http://www.hospicecares.org/default.htm
Provides links on many topics related to hospice and death and dying, including on-line discussion groups.

National Hospice and Palliative Care Organization www.nhpco.org
Basic information on hospice care, selecting a hospice provider, and communicating end-of-life wishes.

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