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Understanding Hospice

What is Hospice Care?

  • Hospice is not a place but a concept of care that is recognized as the model of quality, compassionate healthcare delivery for people facing life-limiting illnesses.
  • In 2019, there were more than 4,800 Medicare-certified hospice providers in the United States that provided care to over 1.6 million terminally ill patients.
  • Hospice care utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes.
  • Support, caregiver training, and grief counseling are available for families and loved ones. Bereavement services are available for a year following the death of the patient. For more information call Donna Avant, Bereavement Coordinator, at 205-523-0101.
  • While most hospice services are provided in the home, care is also available in most skilled nursing facilities, residential care settings, and inpatient hospices such as the Helen H. Hahn House at Hospice of West Alabama.
  • Hospice allows the illness to follow its natural course. The focus is on caring, not curing.
  • Hospice provides care regardless of diagnosis.
  • At the center of hospice is the belief that each of us should be able to die pain-free with dignity, and that our families receive the necessary support to allow us to do so. 

Hospice Care is Not Limited to Six Months of Service

  • While many insurance companies, as well as the Medicare Hospice Benefit, require that a terminally ill patient have a prognosis of six months or less, there is not a six-month limit to hospice care services.
  • Hospice eligibility requirements should not be confused with length of service.
  • A patient in the final phase of life may receive hospice care for as long as necessary when a physician certifies that he or she continues to meet eligibility requirements.
  • Under the Medicare Hospice Benefit, two 90-day periods of care (a total of six months) are followed by an unlimited number of 60-day periods.
  • About 14% of hospice patients receive hospice care for six months or longer.
  • Hospice services are covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations. Hospice of West Alabama also benefits from being a United Way agency and from community donations, ensuring that no one physically appropriate for hospice care is turned away.

Americans are Aging

  • According to the US Census Bureau, the number of Americans age 65 and over was approximately 55.9 million in 2021 and is expected to increase, making up 21% of the population in 2030.
  • By 2035, the 65-plus population will reach 78 million, and for the first time in US history, will outnumber children.
  • It is projected that by 2060 those 65 and over will reach 95 million, consisting of nearly 1 in 4 Americans.
  • The number of people over age 85 is expected to nearly triple by 2060 to 19 million.
  • It is estimated that there are more than 82,000 people who have reached 100 years of age. In the next 40 years, that number is expected to reach 589,000.

Increasing Awareness is Vital

  • While the number of Americans receiving hospice and palliative care grows each year, NHPCO estimates that for every patient who receives hospice, two more patients could benefit from the comprehensive services hospice provides but do not receive this special care.
  • In 2019, NHPCO statistics reveal that half of hospice patients were enrolled for less than 19 days, often an inadequate time for the patient and family to take advantage of the range of available services.
  • Many people are unaware that hospice care is available for nursing facility residents.
  • Lack of awareness of hospice means that too many Americans still die alone or in pain. Too many patients are being referred to hospice care too late, or not at all. And too many families are left without bereavement support.
  • U.S. Department of Health and Human Services has indicated that expanding the reach of hospice care holds enormous potential benefits for those nearing the end of life, whether they are in nursing homes, their own homes, or in hospitals.

Hospice is the Care Americans Want

  • Research by the National Hospice Foundation identifies the top four concerns Americans have surrounding end-of-life care:
    • Someone to be sure that the patient’s wishes are enforced;
    • Choice among the types of services the patient can receive;
    • Pain control tailored to the patient’s wishes; and
    • Emotional support for the patient and family.
  • Research has consistently shown that almost 80% of Americans would prefer to die in their homes, free of pain, surrounded by family and loved ones. Hospice makes this happen. However, of the 2.8 million people who die in this country each year, only 25% actually die at home.
  • Research has also found that people are willing to have an outside organization come into their homes and assist with care for a family member in the last stage of life. Sixty-six percent would welcome help from an outside organization, like hospice, while 24% would prefer to take care of the family member by themselves, with the help of family and friends.
  • NHPCO reports that only 7.4% of all patients who died under hospice care in 2016 died in a hospital.
  • Hospice and palliative care addresses the major concerns of most Americans.

Revised November 2022