Tag Archives: hospice care

Hospice Facts and Figures


The latest report from the National Hospice and Palliative Care Organization (NHPNO) offers important and meaningful statistics regarding hospice care in the United States. The most recent year for which full stats were available is 2013.

The average time that a patient was on hospice in 2013 is 72.6 days.

Among hospice patients in 2013, 34.5% were on hospice 7 days or less before death occurred. 14.3% were on hospice for 8-14 days. Another 12.7% were on hospice for 15-29 days. This means 61.5% received care for less than a month. (We presume that many of that 61.5% might have qualified for hospice sooner and received a more complete assortment of hospice services.)

66.6% of hospice patients were at home in 2013 when they passed away. That number is composed of 41.7% who were in private residences. 24.9% were in nursing homes or other residential facilities.

Approximately 84% of hospice patients in 2013 were age 65 or older. 41.2% were 85 or older.

Of those admitted to hospice in 2013, 36.5% had a cancer diagnosis. The majority, 63.5%, had non-cancer diagnoses. Those included dementia (15.2%), heart disease (13.4) and lung disease (9.9%).

Family evaluations of hospice care after their family member’s death included this positive result: 73.5% of those surveyed rated their family member’s care “excellent.”

According to NHCPO estimates, the number of hospice volunteers serving patients topped 355,000 during 2013. They provided approximately 16 million hours of volunteer service.

The Medicare hospice benefit covered 87.7% of hospice patients in the U.S. during 2013. Medicaid, managed care and private insurance covered 10.0%.

These cold, hard stats are useful but they cannot describe the warmth and compassion that most hospice employees and volunteers have for their patients and families. The numbers are impressive, but it is important to remember that, ultimately, hospice care is about quality rather than quantity.

For information about hospice care in metro St. Louis, please call Hope Hospice at 314-984-9800.


Hospice? Upbeat?


Is it possible that hospice care can be administered with an upbeat attitude? With smiles and laughter? Can the period when a patient is on hospice anticipating end-of-life be a time that also has positive experiences? At Hope Hospice, we believe the answers to these questions are, generally speaking, yes.

Certainly we take our work seriously. We know that an approaching passing can engender great stress for patients and families. We respect the fact that intense feelings of sadness have occurred and will continue to occur.

Of course, circumstances vary from patient to patient and family to family, but we work to balance those unhappy moods with warm, pleasant greetings and visits that, while acknowledging the reality of the situation, bring comfort to our patients.

We know that each day is a new experience for all of us. Life’s small pleasures are to be savored: a song, a story, a joke or just a chat about the simplest of things. If the opportunity exists to brighten a patient’s day, even just a little bit, we do what we can. If we can make a patient smile, that’s a positive experience for all concerned.

For a hospice patient, often one particular day may be better than others. Taking advantage of those good days and enjoying small pleasures is something we encourage. Knowing what lies ahead should not prevent patients and caregivers from sharing those brighter moments as they occur.

For information about hospice care in metro St. Louis, call us at Hope Hospice at 314-984-9800. We are happy to answer any questions you may have about hospice.

(photo credit: http://www.flickr.com/photos/26224875@N02/3974382336, http://photopin.com, https://creativecommons.org/licenses/by/2.0/)

Hospice Care: No Limits

Recent statistics gathered by the National Hospice and Palliative Care Organization (NHPCO) state that 1.65 million Americans are cared for by hospice organizations each year. The number continues to grow. Why? Because hospice provides the care Americans have said they want.

A Gallup poll has determined that 88% of Americans would prefer to die at home, free of pain, surrounded by loved ones. This is what hospice care makes possible. As a whole, our nation’s hospices appear to be doing a good job. 94% of Americans who’ve had family members in hospice rate the care received as good to excellent, according to NHPCO research.

One of the key messages that hospices nationwide are communicating to the public deals with the six-month time period. The major qualification for hospice care is a prognosis indicating that a patient has six months or less to live. But there is not a six-month limit on hospice service.

A patient may receive hospice care for as long as necessary when a physician certifies that he or she meets eligibility requirements.

Under the Medicare Hospice Benefit, two 90-day periods (six months) are followed by an unlimited number of 60-day periods.

Because there is the six-month prognosis requirement AND the initial enrollment period for hospice is also six months, there are misunderstandings. Some patients and family members may fear that if the patient does not die within the six-month period, the patient will be dismissed from hospice. But that is not the case.

Hospice patients do not have to worry about “using up” their hospice benefit.

Even though hospice care is becoming more popular in America and familiar to more Americans, the education process regarding hospice care is an ongoing effort. If there is an aspect of hospice care that is not quite clear to you and your family members, call us at Hope Hospice at 314-984-9800.

Hope Hospice provides hospice care to residents of St. Louis city and county, Jefferson county, St. Charles county and Franklin county.







Dying at Home

Home. It’s a word that has many meanings and connotations. For most of us, home is the place where we are most comfortable. It is the place where we enjoy the company of family and friends. Home is a place where we can relax and be ourselves.

Home is also one of the most important reasons people choose hospice care. Surveys have shown results stating that a huge majority of Americans would prefer to die at home, as opposed to dying in a hospital. If you have ever been a hospital in-patient, you know that while the care can be excellent, it is always a relief when you are allowed to go… home.

Home is not just a favorite chair or a view out the back window. Home is the smell of fresh coffee, bacon and microwave popcorn. Even if a patient’s appetite is curtailed, the smells of home bring pleasure and solace.

Home is a place where friends and neighbors feel more comfortable. It’s easier, in almost all cases, for them to drop by and visit a patient in his or her home than it is to visit in a hospital room. A hospital visit can involve parking garages and confusing layouts, in comparison to parking in a driveway and walking in the front door.

Home is where the pets are. Dogs and cats and other animals are important parts of our lives. Just having them around contributes to the overall feeling of contentment a person feels when at home.

Home is sound that adds to the peacefulness a patient enjoys in his or her home. That sound can be the familiar hum of a kitchen appliance or the voice of a favorite personality on radio or TV echoing in the family room.

Home is where a patient can control the thermostat or request that a caregiver make it warmer or cooler. A patient can enjoy a cozy fire in a fireplace at home…an experience that cannot be replicated at a hospital.

If you have a loved one who is currently considering hospice care or if you’re just thinking ahead to that time when your parent or spouse—or you yourself—may need end-of-life services, remember what they say: There’s No Place Like Home.

Hope Hospice provides hospice care to patients in homes throughout St. Louis city and county and in St. Charles, Franklin and Jefferson counties. Call us anytime for information at 314-984-9800.

Will I Die Sooner on Hospice?

In a word, the answer is “no.” Hospice care neither speeds up nor slows down the dying process. It might appear that, after aggressive hospital treatments are stopped, terminal illnesses would progress at a more rapid pace.

Various research projects have shown that patients on hospice care in many cases actually live longer than those with similar conditions receiving treatments such as chemotherapy. Factors other than purely medical ones—such as the comfort of sitting at home in one’s favorite chair—may play a role in those results.

The Boston doctor who wrote an excellent article about hospice care in The New Yorker magazine in 2010 cited an actual study of 4,493 Medicare patients on hospice. The research compared average survival times of patients on hospice versus those not on hospice care.

That research revealed that patients with pancreatic cancer live, on average, three weeks longer on hospice care. Those with lung cancer had six weeks more survival time on hospice care. Persons with congestive heart failure had, on average, three additional months of life on hospice. There was no significant difference for those with breast cancer, prostate cancer or colon cancer.

Click HERE to read the article.

Of course, there is no way to predict how a particular patient’s conditions will progress under hospice care. And every individual is different.

We sometimes read of celebrities going on hospice care and then, just a few days later, dying. This gives the wrong message that hospice care is only for those who are days away from passing. It also implies that being admitted to hospice care means a patient will die in short order.

Along with communicating that hospice care does not speed up the dying process, all hospices, including Hope Hospice, must continue telling the general public and the medical community that hospice care is not just for the very few last days of a person’s life. Most hospices frequently receive comments from family members and other survivors who say, “We wish we had called you sooner.”

Celebrating Father’s Day with Your Dying Father

For family members whose fathers are in hospice care, dealing with a terminal illness, Father’s Day can be a painful occasion.

Last month, family members of mothers who are receiving hospice care and facing death may have had difficulties experiencing Mother’s Day.

As with Christmas, Thanksgiving and other holidays that are major milestones in our lives, these “special” days can have extraordinary meaning. When we think that next year on Father’s Day, our father may not be with us, it can be overwhelming.

Hope Hospice chaplain John Wilson agrees that, for some, the prospect of a loved one’s yet-to-come passing may be as hard to face as the grief that follows death.  For a caregiver and other family members, anticipating what lies ahead can be stressful.

To those individuals who may be thinking, “this will probably be dad’s last Christmas (or Father’s Day),” Wilson urges family members to “enjoy these moments and involve and engage that person as much as possible.”

Spending time with your father is something a loving son or daughter should do when dad is in good health. Sometimes work and other priorities prevent our being able to be with him. But as death approaches, the effort must be made to spend time with one’s father as often as possible—even if he is hundreds of miles away.

Try not to avoid that Father’s Day visit, even if you fear it may be too much to bear. It’s okay to be sad and even to shed a tear. But while you dad is still around, your Father’s Day visit is one to be savored and remembered. If you think it will cause sorrow, consider the disappointment if you choose not to visit.

If you have concerns about visiting a dying father on Father’s Day or about the approaching death of a family member, call chaplain John Wilson at Hope Hospice at 314-984-9800.






More On The Cost/Value Of Hospice

An amazing statistic appeared in a recent New York Times op-ed column. According to writer Susan Jacoby, “A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month.” The column also states “the average hospital stay costs Medicare over $6,000 a day.”

Those are startling numbers. If you have recently filed taxes, you may have noted on your W-2 form the significant amount of your 2011 income that went directly to Medicare. (And that amount is not deductible.) Whatever the amount, you would probably have preferred to have that money in your own pocket.

Consider the amount of money that could be saved by Medicare (and we whose contributions fund it) if those who are dying in hospitals chose to die at home, under hospice care.

Another note regarding the massive hospital bills that are accumulated by those who prefer to die connected to tubes and monitors in a hospital: families are often obliged to pay some of the costs that are not covered by Medicare, including the tab for certain drugs. Whereas patients on hospice care are not obliged to make additional payments to the hospice agency.

How do you know if your loved one would prefer to spend his or her last weeks and months in the comfort of home? (As opposed to being in a hospital.) You ask. And you ask early in the dying process, when the patient still has a grip on reality.

These conversations can be difficult to get started. But once the topic is addressed, you may discover that your loved one has thoughts and desires that have never been voiced. And, like with many such dialogues we conduct in our lives, they often turn out to be much less uncomfortable than anticipated.

Hospice care is a money-saver for Medicare when compared to the cost of hospital in-patient care. Hospice care can also be a money-saver for families of patients whose hospitalization coverage is less than complete. But the main concern of families and health care providers should be patient comfort. That is always the top priority of Hope Hospice staff and administrators.

To learn more about hospice and all the elements of care provided, call Hope Hospice at 314-984-9800. Or click on HopeHospiceStL.com.