Hospice

Hospice care is a type and philosophy of care that focuses on the palliative care of a terminally ill or seriously ill patient's pain and symptoms, and attending to their emotional and spiritual needs. Within the United States the term is largely defined by the practices of the Medicare system and other health insurance providers, which make hospice care available, either in an inpatient facility or at the patient's home, to patients with a terminal prognosis who are medically certified to have less than six months to live. Outside the United States, the term hospice tends to be primarily associated with the particular buildings or institutions that specialise in such care (although so-called "hospice at home" services may also be available). Outside the United States such institutions may similarly mostly provide care in an end-of-life setting; but they may also be available for patients with other specific palliative care needs.

The focus of hospice care is on palliation of the patient's pain and symptoms. These symptoms may be physical, emotional, or psychosocial in nature. Hospice care focuses on bringing comfort, self-respect, and tranquility to people in the final years of life. Patients’ symptoms and pain are controlled, goals of care are discussed and emotional needs are supported. Hospice believes that the end of life is not a medical experience, it is a human experience that benefits from expert medical and holistic support that hospice offers. The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims. The modern concept of hospice includes palliative care for the incurably ill given in such institutions as hospitals or nursing homes, but also care provided to those who would rather spend their last months and days of life in their own homes. It began to emerge in the 17th century, but many of the foundational principles by which modern hospice services operate were pioneered in the 1950s by Dame Cicely Saunders. Hospice care also involves assistance for patients’ families to help them cope with what is happening and provide care and support to keep the patient at home. Although the movement has met with some resistance, hospice has rapidly expanded through the United Kingdom, the United States and elsewhere.