People with terminal illnesses may not have years ahead of them, but hospice nurse Kara Crouch hopes she can help them find comfort and purpose in each day. “I like to allow patients to participate in their own journey. People can write their own story about how they want to live while they’re here.”
Crouch is part of an interdisciplinary team of professionals with OhioHealth HomeReach Hospice in Athens that provides medical, emotional and spiritual support to terminally ill patients and their families.
Choosing hospice care “is not giving up, it’s about changing your mindset,” Crouch said. “Instead of focusing on curative efforts, you’re looking at the quality of your life. You can examine what the next six months would look like experiencing the effects of chemotherapy and radiation, versus what it would be like without them.”
Who is eligible for hospice care? Does insurance cover it?
Hospice care is intended for someone with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course. Usually, a patient’s doctor initiates a referral to hospice and “re-certifies them” every couple of months as needed. Hospice care can be extended as long as the patient remains medically eligible.
Medicare, Medicaid and many private insurance plans pay for hospice care; it’s estimated that about 1.9 million Medicare recipients received hospice services in 2024.
What kind of services does hospice provide?
“Hospice provides care on many levels. We address physical pain and shortness of breath, and also emotional and spiritual distress,” Crouch said. Hospice teams include physicians, nurses, chaplains, social workers, bereavement counselors, respiratory therapists, aides and volunteers.
“We are incredibly diverse. We are with these families so much, we become part of the family. Hospice is an immersive experience.”
Hospice professionals use “comfort packs” containing medications to address pain, nausea, anxiety, constipation, fever and agitation. The comfort packs are tailored to meet each patient’s specific needs, and patients experiencing shortness of breath can receive supplemental oxygen, Crouch said.
What are common misconceptions about hospice?
- Hospice care is not just for cancer patients. “It’s a broad spectrum,” Crouch said, and includes people with heart and vascular disease; Alzheimer’s, kidney and liver diseases; chronic obstructive pulmonary disease (COPD); and amyotrophic lateral sclerosis (ALS) , also known as Lou Gehrig’s disease.
- Hospice medications do not hasten death. “People die of the disease they have, not the comfort medicine they’re given,” Crouch said.
- Stopping treatment aimed at curing the terminal illness does not mean discontinuing all medication. For example, patients may still take blood-pressure medicine.
- There is no requirement to remain in hospice if a patient changes his or her mind and wants to pursue treatment, such as participating in a clinical trial.
What is the difference between hospice and palliative care?
Both hospice and palliative care provide comprehensive comfort care and support for the patient and family; however palliative care can be offered at any stage of a serious illness, alongside curative treatments. Hospice is tailored specifically to patients in the final stages of life who don’t qualify for or want to pursue further treatment.
Where is hospice care delivered?
Hospice care happens in a variety of settings, including homes, hospitals, hospice homes and assisted living and nursing home facilities. For those receiving care at home, OhioHealth Home Reach Hospice provides equipment such as beds and other equipment and supplies, along with 24-hour telephone access to nursing support. Depending on the nature of the concern, nursing staff handle issues over the phone or make in-person visits if necessary, Crouch said.
With regular and ongoing patient monitoring, “we tend to catch symptoms before patients need to be hospitalized urgently,”Crouch said. Home care also allows patients to be in comfortable, familiar surroundings with loved ones and devoted pets close by.
As difficult as end of life may be, there are bright moments, Crouch said. “One of my favorite things is watching families patch up relationships – it actually can be a joyous thing.”
Crouch likens the process of dying to birth because each has specific stages. “As a society, we avoid the topic of death. I wish this was something that was taught in school. Education is so important in helping people understand death and be less afraid.”
For more information on hospice care, visit https://www.ohiohealth.com/services/hospice or call 614-566-5377.
