Hospice Services in the United States

Hospice Services in the United States



     Technology has undoubtedly changed every aspect of our lives, with health care being no exception.  As a matter of fact, the way that modern people die has been affected as much as how modern people live.  One of the most sweeping changes in the process of gradual death due to terminal disease, not only in the United States but elsewhere worldwide is the advent of  hospice services.  This research will take a look into various aspects of hospice services in the US as a way of better understanding this evolving topic.

The History of Hospice Services in the US

     Before being able to accurately discuss the more intricate aspects of hospice services in the US, a brief history of these services is in order.  To do this, a trip is taken back in time to the US of the early 1970s.  At that time, the health care community as a whole was focused on the prevention of disease rather than helping those who were terminally ill, as illustrated by the billions of dollars dedicated to President Nixon’s “War on Cancer”.  In fact, the subjects of death and dying were basically taboo at the time, even from the viewpoint of clergy members who generally shied away from the terminally ill due to a lack of ability to approach them properly, and the only people who received end of life care at home were the extremely wealthy who had the ability to essentially reproduce the hospital setting at home, complete with paid nurses, doctors and equipment.  By the late 1970s, however, the US took a cue from Great Britain, generally recognized as the creators of modern hospice care, and began to embrace hospice as a valid method of care for the terminally ill, a fact validated by the inclusion of hospice by Medicare as a legitimate medical treatment, qualified for payment under that health care program by 1980 (The Hastings Center Report, 2003).

     Initially, hospice was focused on care for those dying of cancer, due to the heightened awareness of the lethality of the disease when hospice first came to the US, but in the modern day is utilized for all forms of terminal disease (Jennings, 2005) and has a major impact on US medical care, which will now be discussed.

How Hospice Services Currently Impact Medical Care in the US

     In the 21st century, medical care in the US, it would be fair to say, is in the midst of a crisis: the massive population of the US, which is only growing with time, has required huge resources in the delivery of health care, as does the fact that the population of the US is shifting toward a much older one.  Naturally, older people require more health care, and resources are further taxed to the limits.  This demand is complicated by the fact that many Americans are either uninsured or underinsured, and the inability to pay for health care, combined with the legal implications that require health care providers to treat people regardless of their ability to pay has led to the bankruptcy of many health care organizations (Noddings, 1994).

     Hospice care represents an opportunity to ease the burden on health care facilities and professionals across the US, has opened up a new field of health care for practioners to embrace and excel in, and also has made it possible for many charitable groups to serve humanity through the provision of hospice care to the American patient.  Therefore, hospice care represents, as will be seen,  affects on the cost factors of health care in the US.

How Hospice Services Will Evolve in the Future

     The future of hospice services in the US is challenging, encouraging and distressing all at the same time.  Because of the previously discussed growth of the overall American population, combined with the aging of the American population, the demand for hospice will only increase with time, posing a challenge for health care providers, who will need to devote financial and human resources to hospice care to deliver the services and to generate revenue that will allow the organizations to grow in the future (Discussing the Future of Hospice Care, 2008).

     As hospice care grows in the future in the US, so too will the likelihood of fraud due to the payment for these services by private insurers, Medicare and the private funds of the wealthy, making it necessary for more oversight on the part of government regulators.  This will also be necessary to ensure that the quality of the care is suitable, as the frequent at home nature of hospice care makes supervision of it quite difficult (Burnham, 1999).

     Evolution of hospice is also happening from the spiritual point of view.  In a stark contrast from the avoidance of terminal illness issues by organized religion in the early 1970s and before, clergy are now embracing hospice care and ministering to the spiritual needs of the patient and their loved ones as preparation is made to depart this life for another one, depending upon the belief set of a given religion itself (Jennings, 2005).

     Lastly, hospice care is becoming more and more prevalent not only as an at home health care option for end of life care, but also as a part of established facilities which not only care for the patient through pain management, counseling of the patient and their loved ones, and what is basically amounting to intense moral support.  With all of this in place, the evolution of hospice care from something in the underground to more mainstream is happening as these very words are being read.

Does Hospice Services Contribute to the High Cost of Health Care in the US or Cost Reduction?

     Hospice services in fact contribute to cost reduction in the US health care system for several important reasons.  To begin, putting aside the moral implications which could very easily fill thousands of pages of research alone, when health care such as hospice for the terminally ill is employed, the focus of the treatment goes from the prolonging of life through artificial means to the easing of terminal illness to a peaceful and painless conclusion.  At the risk of sounding crass with the equation of life with money, hospice simply costs less than keeping human beings connected to life support equipment, kept alive with expensive drugs, and supervised by highly paid medical professionals.  Second, at any rate, home care is much less costly than that which is provided in hospitals or clinics and hospice care has the unique characteristic that it is often delivered by family members or unpaid volunteers, adding to the cost savings (Burnham, 1999).

Why  the Topic Interests the Researcher

     From a personal standpoint, the topic of hospice care interests the researcher for many reasons: first, as a member of the world economic community, any opportunity to ease the financial problems of the world is of interest as it ultimately trickles down to the economy of every person on the face of the earth.  Second, as a compassionate human being, the researcher is very interested in any way that others in need can be helped and suffering eased.  Lastly, at the risk of sounding selfish, the availability of hospice care is interesting to the researcher, as it provides peace of mind, knowing that should a lingering terminal illness strike, there are ways to ease pain, suffering and emotional distress without going bankrupt or burdening loved ones in the process.

Closing Thoughts

     Just as compassion for the living is morally right, so too is compassion for the dying.  It is this compassion that has fueled the popularity of hospice care in the US, which provides the ability for terminally ill patients to die with dignity, comfort and support from those that care about them the most.  Additionally, as has been seen, hospice care represents an opportunity to unburden the US health care system from the standpoints of expenses, capacity to deliver services and personnel demands.  Therefore, in closing, it is fair to say that hospice care will continue to have an increasing validity in the United States and elsewhere.

Works Cited

Burnham, R. (1999, March). HOSPICE CARE: Making an Informed Choice. USA Today (Society for the Advancement of Education), 127, 58.

Discussing the Future of Hospice Care (2008, May). Retrieved November 25, 2008 from the World Wide Web: http://www.hospicefoundation.org/blog/2008/05/discussing-future-of-hospice-care.html

Jennings, L. (2005, March/April). Finding Better Ways to Die: The Most Frightening Future of All May Be the One We Always Face Alone. Death Is a Future That We Can Almost Guarantee but One That Even Many Futurists Ignore. New Options May Make Death Less Frightening, and Foresight and Planning Might Improve Our Last Days. The Futurist, 39, 43+.

Noddings, N. (1994). Moral Obligation or Moral Support for High-Tech Home Care?. The Hastings Center Report, 24(5), 6+.

What Is Hospice Care?. (2003). The Hastings Center Report, 33(2), 6+.


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