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Home & Hospice Care
of Rhode Island
Celebrates
30 Years of Leading the Way
Hospice:
A Quiet Health Care Revolution
When we think
of health care breakthroughs, we usually think of new surgical procedures
or miracle drugs, not hospice care. Hospice’s story, however, is
unique and remarkable. In just three decades, hospice has quietly
revolutionized the way people die in America by honoring wishes
and bringing peace, dignity, and comfort to millions of patients
and families. Home & Hospice Care of Rhode Island
(HHCRI) has been a part of this health care revolution by providing
end-of-life care for 30 years.
In the early 1970s, groups
of volunteers, comprised primarily of clergy, social workers, nurses,
and physicians began gathering to discuss ways to improve end-of-life
care in Rhode Island. Influenced by the work of Dr. Dame Cicely
Saunders, a physician from England, who in 1967 created the first
hospice program at London’s St. Christopher’s Hospital, these hospice
pioneers explored ways to ease the burden of individuals and families
coping with life-threatening illnesses.
During the past 30 years
the hospice movement has dramatically transformed end-of-life care.
Convincing the medical establishment to consider hospice for their
patients was and still is a challenge. Doctors, after all, are trained
to cure. Today, although there are still many physicians who are
reluctant to declare a disease incurable, hospice care has become
an integral part of the healthcare continuum of care.
Three decades ago, pain was
viewed as unpreventable. Today, through the efforts of many, including
the Attorney General’s Task Force on End-of-Life Care, the medical
community’s attitude toward pain has changed. It is no longer acceptable.
Hospice has become an accepted plan of treatment with pain management
as a vital component.
Certainly the profile of
diseases being treated has changed. Early on, primarily cancer patients
enrolled in hospice. Today, the National Hospice and Palliative
Care Organization (NHPCO) reports Cancer accounts for 46% of hospice
admissions with End-Stage Heart Disease (12.2%), Dementia (8.9%),
Debility (8.2%), Lung Disease (7.1%) and End-Stage Kidney Disease
(3.1%) among the top 5 non-cancer diagnoses.
The hospice movement has
experienced phenomenal growth. According to the National Association
of Hospice and Palliative Care (NHPCO), there are close to 4,000
hospice programs in the country. In 1974, there was one program.
Home & Hospice Care of Rhode Island saw its first patient in
1976 thus becoming the 3 rd oldest hospice in the country. In the
late 1970s, HHCRI had a staff of nine and were seeing an average
of 10 patients each day. Thirty years later, Home & Hospice
Care of Rhode Island has a staff of 250 and is caring for more than
400 patients a day.
In its early days, hospice
care was delivered primarily in the home. Studies show that most
individuals prefer to stay in the comfort of their home surrounded
by the love and support of family. However, many individuals have
no support system at home or may be too ill to stay at home. Today,
Hospice care is offered in nursing homes, assisted living facilities,
hospitals, group homes and even prisons – wherever a person calls
home. Hospices throughout the country, including Home & Hospice
Care of Rhode Island, are collaborating with various healthcare
providers to offer hospice care in their facilities. Home &
Hospice Care of Rhode Island has over 75 contracts with nursing
homes in the state and is collaborating with hospitals throughout
the state to enhance end-of-life care in their facilities.
In 1992, Home & Hospice
Care of Rhode Island opened The Philip Hulitar Inpatient Center,
a 10-bed in-patient unit that provides a safe, nurturing, home-like
environment for individuals requiring intense symptom management
and pain control, a place for short term stays in between leaving
the hospital and returning home, and an alternative setting for
a patient to remain comfortable during his/her final days of life.
Today, it’s the only free-standing inpatient setting of its kind
in the state.
Perhaps the most significant
change came in 1983 when the Federal Government introduced the Medicare
hospice benefit to cover hospice-related expenses. The Medicare
hospice benefit covers palliative and support services for beneficiaries
who have a life expectancy of six months or less if the disease
runs its normal course. A physician must certify the prognosis for
a patient to be eligible to elect hospice. Prior to 1983, there
was no insurance coverage for hospice care. Today, hospice services
are covered by the Medicare hospice benefit and most private insurance
companies, including Blue Cross Blue Shield of Rhode Island and
United Healthcare.
Despite this quiet health
care revolution, challenges remain. National, regional, and HHCRI
trends indicate that people with life-threatening diseases are seeking
more and varied forms of treatment and are turning to hospice much
later in their illness. Too often, referrals to hospice from healthcare
providers are postponed until the very last days or hours of a patient’s
life. Unfortunately, most Americans have not yet begun to understand
the value of hospice. Hospice care should not take place hours before
you die.
When patients and families
choose hospice, they receive care unlike any other. Hospice goes
to the patient, treats pain and symptoms with aggressive medical
care, and eases the emotional and spiritual suffering of patients,
families, and loved ones. A team of dedicated and caring medical
experts, professionals, and members of the community makes it possible
–doctors, nurses, certified nurse assistants, social workers, spiritual
coordinators, trained volunteers and bereavement counselors.
This care, plus coverage
of medications for pain control and symptom management of the illness,
is available to patients and their families at little or no cost
through the Medicare hospice benefit, most private insurance plans,
and other managed care organizations .
Additionally, community contributions, memorial donations,
and foundation gifts help to offset expenses not covered by insurance.
Hospice gives patients and
families more control over end-of-life decisions, improving the
quality of life, and diminishing the financial impact of a life-threatening
illness.
True – hospice care isn’t
a major medical breakthrough. But, in a quiet way, it is having
a dramatic impact on the lives of those dealing with end-of-life
issues. You don’t have to face the end of life alone. Home &
Hospice Care of Rhode Island can help. For more information or answers
to your questions regarding care for your loved one, please call
800-338-6555.
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