Very often when we hear the word “hospice” it comes as a shock for many people. People immediately assume a person is actively “dying.” One day we all will come face-to-face with our own mortality. Hospice is a philosophy of care focused on comfort, quality of life, and assisting those nearing the end of life. Hospice celebrates life and supports the individual needs of the patient and loved ones.

After receiving a diagnosis of a limited life expectancy, patients make an important choice be-tween hospice care and aggressive medical treatment. When a cure is no longer possible and comfort care is desired, hospice can help support the patient and her loved ones in improving quality of life and assisting in meeting end-of-life goals.

Aria Hospice care neither prolongs life nor hastens death but relieves pain and physical discomfort so that the patient can better fulfill their emotional and spiritual wishes.

Many people mistakenly believe that hospice patients are bed-bound, critically ill, and unable to continue living life to the fullest. Hospice is often misunderstood and looked upon as a type of care that is provided only during the last few days of life. This is unfortunate for the patient and the family members, because without hospice, or waiting too long before coming into hospice, there is the potential to deny a person the opportunity for enhanced comfort, improved quality of life and the ability to come to a peaceful closure with the people that surround us.

Hospice Eligibility

Individuals are eligible for hospice care if they have a life expectancy of six months or less. Knowing what options regarding healthcare are available, will allow you to determine when you or your loved one qualifies for hospice care.  Examples of signs that may indicate a person is eligible for hospice care are:

Hospice in the United States

Hospice originally dates to medieval times when it was a place where weary travelers could find shelter and temporary respite from their journeys.  Religious groups operated these shelters for travelers on religious pilgrimages but as time passed, they began to care for the sick, hungry, and weary.  The word hospice comes from the Latin word “hospices” meaning host and “hospitium” meaning hospitality.

The modern hospice can be traced to the Irish Sisters of Charity who established St. Joseph’s Hospice in London in 1905.  However, the modern concept of hospice care as we know it  today was pioneered and defined, in large part by Dame Cicely Saunders, a British physician who opened St. Christopher’s Hospice in London in 1967.  It was through her work that the philosophy of emphasizing pain and management control rather than curative care was established.

In the United States, the hospice movement started later than it did in England and was enhanced by the work of Elisabeth Kubler-Ross who wrote On Death and Dying in 1969. Through the efforts of many professional and laypersons, the hospice movement continued to advance, and the first United States hospice program began in New Haven, Connecticut in 1974.

Hospice continued to flourish in the United States and across the country. These programs were primarily volunteer or non-profit based and the vast majority were home care programs.  In 1982, Congress passed the Medicare Hospice Benefit, which expanded hospice care availability for the Medicare eligible population.  This first attempt at legislation contained a “sunset clause,” however, in 1986 this clause was removed, and hospice care became a permanent Medicare benefit.  The legislation included a definition of “home” as “wherever the patient lives” resulting in the ability to provide care in Skilled Nursing Facilities and in most states, Assisted Living Facilities. Also, at this time, states were given the option of providing hospice services under the Medicaid program and later private insurance and managed-care companies followed suit.