Report examines the underuse of hospice services

By Mary Kuhlman
Ohio News Connection

COLUMBUS, Ohio - For many, entering hospice care often is viewed as an indication of imminent death, but the hospice industry is trying to help people understand that its benefits can begin well before someone is in dire health.

Hospice care can provide pain management as well as emotional and spiritual support, tailored to a patient's needs. According to a new report, however, more than 40 percent of Medicare patients on hospice in 2015 received just 14 days of care or less.

Edo Banach, president and chief executive of the National Hospice and Palliative Care Organization, said hospice works not just in a person's final days but over the last months of his or her life.

"You really have an ability to begin to make some changes that are going to make people more comfortable," he said. "Less than that, you're really doing the best you can do, but you're not having as much of an impact on an individual's life and making their life as comfortable as it can be."

Banach said it takes time for a hospice team to work with patients on what their wishes are - and to work with families to put a plan in place for medications, counseling and bereavement services. The report found 46 percent of Medicare recipients received at least one day of hospice care at the time of death, but nearly three out of four received less than 90 days of care.

New strategies are needed to get more people the help they need when dealing with the physical and mental symptoms with which families can struggle at the end of life, Banach said. He noted that the interdisciplinary hospice model provides not just medical care but psycho-social care as well, which could become even more important as the nation grapples with mass shootings and natural disasters.

"And in this time when we're dealing with wildfires, and we're dealing with hurricanes, and we're dealing with opioid crises," he said, "I do want to think about how a model that provides for all those other services and provides bereavement services might have a really strong role to play in the future of health care in this country."

The report found that not all Americans benefit from hospice care equally. Banach said African-American families in particular continue to be underserved both in terms of the number of care days and the number of patients receiving care.

The report is online at nhpco.org.