According to national hospice utilization data, Vermonters appear to avail themselves of hospice services at a lower rate than residents of other states. While there are likely many reasons, education should not be one.
Hospice is an end-of life care model of coordinated services and support for patients and their families. The focus is on quality care, comfort, and pain management, not treatment. Individuals enrolled in hospice receive compassionate care from an interdisciplinary team that may include medical providers, spiritual advisors, therapists, social workers, and volunteers. It is the team’s goal to provide support that is specifically tailored to the needs and wishes of the patient and family.
To be eligible, a referring physician must determine that the patient’s diagnosis and projected condition suggests a life expectancy of less than 6 months. According to recent national statistics, the primary diagnosis of the largest percentage of patients admitted to hospice is cancer (accounting for just over 1/3 of individuals), followed by dementia, heart disease, lung disease, and stroke or coma.
While most patients receive this support at home, hospice may also be provided in a center, such as the Vermont Respite House, as well as hospitals, nursing homes, and residential care facilities. Most of the care is provided by Medicare, a benefit available since 1982. In Vermont, hospice agencies certified by the Centers for Medicare and Medicaid to provide this benefit include VNA and Bayada. Other payment sources include Medicaid, private insurance, or self-pay.
Although end-of-life care and its related decisions can present challenges for both the patient and family, there is help available, one that appears to underutilized. Families should ask questions often and early, to ensure the best quality of care—whether in treatment or comfort phase.