Editorial: New facility aims for comfort at end of life

The opening of Hospice House in Coeur d’Alene is great news for the community and an indication that hospice care is gaining widespread acceptance. A 12-bed facility opened in Spokane in 2007.

The 14 warmly decorated rooms at the Idaho facility will offer what many families want for their loved ones during battles with terminal illnesses: serenity and dignity. While most hospice care occurs in private residences, some illnesses require the greater medical attention that a hospice house can provide. The facility can also serve as a transition point from hospital to home.

Hospice has been around for several decades, but many are still unaware it is available as a health care choice. It was added to Medicare in 1983 and subsequent congressional acts have increased the value of the benefit. Along with offering an alternative to living out the final days in the cold, forbidding environments of intensive care units, hospice saves the government money.

A 2007 Duke University study showed that hospice reduced Medicare spending by $2,309 per patient compared to normal care. That’s not surprising when considering that nearly one-fourth of Medicare spending is directed toward the last year of life.

Before visions of “death panels” arise, note that hospice is voluntary and patients need a medical prognosis of a terminal condition with a short life expectancy to qualify. Increasingly, more patients are choosing comfort over the fruitless, painful procedures that may keep them alive a little bit longer. Medicare has seen participation rise from 7 percent of patients in 1990 to 30 percent by 2006.

Choosing hospice undercuts one of the main cost drivers in the U.S. health care system, because it encourages people to establish end-of-life directives, which put them in charge of deciding what quality of life they want in their final days. It also takes significant pressure off family members who don’t have to guess the wishes of loved ones.

Once hospice is selected, the focus is on pain control and comfort so that patients can spend their final days as they see fit. Hospice professionals offer a gentle, reassuring presence to complement the spiritual and emotional experience of families saying their final goodbyes. Families who have experienced hospice care often marvel at how meaningful that time can be. Grief counseling is available for those who want help coping with their loss.

Society’s growing comfort with talking about death and dying has paved the way for hospice care. In return, hospice has helped families celebrate life.