Hospice is a way to deal realistically and compassionately with the end of life. It offers the hope of dignity and comfort. Hospice is a family-oriented program that helps families and friends care for their loved one in their home, in a nursing home or in an assisted living facility. Hospice is not a substitute for the family or the family’s care. Hospice workers help patients make the most of each day. Hospice neither hastens nor prolongs death. Hospice seeks to let nature take its course while managing any pain that might be part of the death process.
The primary goals of hospice care are to:
- Relieve the physical, mental, emotional and spiritual suffering of our patients and those who care for them
- Promote the dignity and independence of our patients to the greatest extent possible
- Support our patients and their families in finding personal fulfillment as they deal with end-of-life challenges
The Team Approach
The Team
Hospice of Westchester brings together a team of specially trained professionals and volunteers who work with the patient’s physician to develop an individualized plan of care designed to control pain and ease end of life struggles for our patients and their families.
The Hospice Team is made up of professionals from multiple disciplines including nursing, social work, spiritual care, bereavement, complementary care and volunteers. All disciplines work under the direction of our hospice medical director. When patients with a terminal illness are supported by an interdisciplinary team of skilled palliative care specialists and volunteers, the last stages of life can become a comfortable and treasured time of new hope and healing. Often, the patient’s physical, psychosocial, and spiritual distress can be relieved through effective collaboration among the team and family members. They form a caring community in which patients can find new meaning, restored integrity, and a dignified close to life.
“The team that came in – the nurse, the caregiver, the therapist – I thought they went above and beyond what they had to do...”
Making Decisions
When faced with a life-limiting or terminal illness, many of the decisions that must be made can be challenging and emotional. These decisions can involve advance directives, funeral arrangements and other important considerations. Even though discussing these topics may bring up challenging feelings, it is important to be proactive and to use effective communication in order to ensure choice and control during difficult times.
At Hospice of Westchester, our social worker is experienced in facilitating a discussion with your family to plan for the future. Following are some guidelines to help you broach potentially difficult subjects.- Plan ahead for the conversation.
- Be sensitive to the fact that you will be discussing emotionally laden topics.
- Choose a place and time that is conducive to an open conversation.
- Keep in mind that you may have to discuss the same topic on several separate occasions.
- Realize that family members may disagree and that the goal is to allow the patient to have a say in the matters being discussed..
- Use “I” statements to get your view and feelings across to others.
- Do not use this time to discuss old wounds or bring up unresolved issues from the past. Try to keep your focus on the patient.
- Be aware that initial decisions may change over the course of time.
- Be compassionate with yourself and those in your family. Everyone deals with emotions differently and there is no right or wrong way.
Hospice FAQs
1When should a decision about entering a hospice program be made and who should make it?
Patients are eligible for hospice care when they have been diagnosed with a terminal illness with a prognosis of 6 months or less. At that time, comfort care, and symptom management become the primary focus, and curative treatment is no longer the patient’s choice or option. After a discussion with your primary care physician, decisions can be made about appropriate medical care. Hospice should be called as soon as the patient has been diagnosed with a life-limiting illness within the 6-month period. It is appropriate to discuss all of the patient’s care options, including hospice and allow the patient to have an active voice if possible.
2Who pays for Hospice?
Hospice of Westchester bills directly to Medicare, Medicaid and/or private insurance for hospice care. We encourage referrals early in the process so the patient and family may receive maximum benefit from the comprehensive services that we provide.
3Where is hospice care provided?
Hospice of Westchester provides hospice care in a setting that best meets the needs of each patient and their family. The most common setting is the patient’s home. Hospice care is also provided in nursing homes, assisted living facilities and hospitals according to patient care needs.
4Are all hospices the same?
No. “Hospice” is a medical specialty like pediatrics, geriatrics, oncology, etc. Each hospice provider is a different company. All hospices have the same general philosophy but their services may differ. In Westchester County, it is your right to request the hospice of your choice if more than one hospice serves your area.
5Can my pain and symptoms be controlled at home?
Yes. Pain and other symptoms can usually be controlled in the patient’s home. If a symptom (i.e. pain, nausea or vomiting, or difficulty breathing) becomes a problem, the hospice nurse can be reached 24-hours a day, 7 days a week. There have been great advances in pain and symptom control in the past few years. Most symptoms can be controlled without the use of injections or IV medication. The nurses at Hospice of Westchester manage each patients’ pain and symptom control at each visit. Our medical director is always available to provide consultation if needed.
6Does Hospice provide 24-hour in-home care?
No. Hospice is not meant to be a substitute for full-time nursing care. Hospice provides intermittent nursing and doctor visits to assess, monitor and treat symptoms, as well as teach family and caregivers the skills they need to care for the patient. Social workers, pastoral care staff, complementary care professionals and volunteers also visit the patient as needed.
7Can a hospice patient choose to return to curative treatment?
Yes. Receiving hospice care is always a choice. A patient may leave hospice and return to curative treatment if that is their choice. If the patient later chooses to return to hospice care, Medicare, Medicaid, and most insurance companies permit re-evaluation of the hospice benefit. In addition, if the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care due to a decline in their condition, Medicare and most private insurance will allow additional a return to Hospice.
8Is the decision for hospice care about giving up hope or waiting to die?
No. Hospice is about living. Hospice of Westchester strives to bring quality of life and comfort to each patient and their family. Our successes are in helping a patient and family live fully until the end of their natural life. Often patients will feel better with good pain and symptom management. Hospice is an experience of care and support, different from any other type of care.
9Does hospice do anything to bring death sooner?
No. Our goal is always to alleviate suffering and manage symptoms. Hospice does nothing to speed up or slow down the dying process. Our role is to lend support and allow the disease process to unfold as comfortably as possible.
10How does hospice “manage pain”?
Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. Physical pain and other symptoms can usually be controlled in the patient’s home. If a symptom (i.e. pain, nausea or vomiting, or difficulty breathing) becomes a problem, the hospice nurse can be reached 24-hours a day, 7 days a week. Hospice medical directors are always available to adjust medications.
At Hospice of Westchester we also believe that emotional and spiritual pain are just as real and in need of attention as physical pain. Our team of professionals are trained to offer interventions for many end of life challenges. In addition, our team of complementary care providers can help with mental or emotional pain through the use of massage, art therapy, music and reflexology.
11Will medications prevent the patient from being able to talk or know what is happening?
Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient and family caregivers, hospices have been very successful in reaching this goal.
12Is Hospice of Westchester affiliated with any religious organization?
No. All denominations are welcome and Hospice of Westchester does not discriminate based on race, religion, gender identity or age.
13Does hospice provide support to the family after the patient dies?
Yes. Bereavement Services follow family and caregivers for a year following the patient’s death. These services may include individual and family grief counseling, peer support groups and other bereavement support as needed. Each patient caregiver is contacted by bereavement services in order to assess their needs.
Virtual Support Group
914-682-1484
During the pandemic many of the supports and rituals commonly used were unavailable, which can make losing a loved one even more difficult. A bereavement support group can provide a supportive environment in which you can understand the impact grief has on your life, learn ways to cope with the loss, and begin to look toward the future with purpose and meaning.