When a loved one has a terminal illness that is imminent or could happen soon, many people have questions about what comes next and how to best support and help their loved one at the same time grappling with their own emotions and the upcoming loss.
Hospice care is available for terminally ill patients to help keep them comfortable, maintain their dignity and help them live their remaining days to the fullest that they can. Hospice providers typically support patients and their caregivers during about the last six months of their life.
Hospice provides experienced and skilled specialists who understand the help and support that is needed during this difficult time. The hospice team works with the attending physician and family to develop and adapt the plan of care, which meets the patient and family needs and wishes over time.
“Supporting the patient is our number one priority for hospice care, but also care for the people that care for them, their family and loved ones. We try to manage their symptooms and minimize the emotional stress and trauma surrounding death for all involved,” said Dr. Jeff McNally, MD the medical director of hospice care at Intermountain Health.
“When you ask people their preference, they usually say they want to die at home. About 90% of our hospice care is provided in a patient’s home, but we also care for patients in assisted living locations and in hospitals. Patients do best when they are in settings they are familiar with,” said Dr. McNally.
Utah has the highest percentage of medicare beneficiaries that die having been on hospice at 61% (as compared to New York at the lowest, which is 25%. A study in 2022 estimated that approximately 80% of people could benefit from hospice services.
To qualify for hospice care, people can have their physician refer them to hospice or they can self-refer their loved one for hospice care. The first step is for a hospice provider to do an evaluation and assessment of the patient, to see if they qualify.
“The timing and duration of hospice care is not pre-determined, there is flexibility and sometimes people may be on hospice briefly, but their health improves and they’re off of hospice care for a time, but then may be on hospice care again later. Every patient and every diagnosis is unique,” said Dr. McNally.
Hospice providers which include doctors and nurses are on-call 24 hours a day, seven days a week. They are specially trained in end-of-life care, and hospice. and Physicians complete a hospice or palliative care fellowship and become certified. Hospice is a standard benefit with Medicare and most insurance plans. Hospice services also include chaplains who provide non-denominational spiritual support.
“All adults, not just those who are terminally ill, are encouraged to make advance directives to record their wishes for end-of-life care. Going through that process ahead of time is beneficial for patients and families so they’re not suddenly dealing with a health crisis and an emotional crisis. The sooner you do that, the better,” said Dr. McNally
It can be hard to admit that you or loved one needs hospice. A lot of people think they’re giving up on their family member and there won’t be other treatment. It doesn’t mean we stop all medications or stop caring for patient. We have medications for pain, shortness of breath, nausea, vomiting, anxiety, confusion and agitation, that are common with dementia.
“After passing, we have a bereavement program, where we follow up to make sure the family is doing ok and we have grief support meetings,” he added.
Intermountain Health has hospice locations in Utah from Logan to St. George.
There is a telemedicine option where the initial assessment can be done virtually by video visit if desired. Later on, during hospice care, some physician visits can be done virtually.
For more information visit the end-of-life care page on intermountainhealth.org.
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.
