Topic: 4

What are Community and Residential Hospice Care?

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What You Need to Know

Many regions in Ontario now have hospices that provide support to families who are caring for a loved one who has a life-limiting illness. A “family” is whoever the person says his or her family is. It may include relatives, partners and friends. These hospices specialize in an approach to care that is called palliative care. Palliative care is a special kind of health care for individuals and families who are living with a life-limiting illness that is usually at an advanced stage. The goal of palliative care is to provide comfort and dignity for the person living with the illness as well as the best quality of life for both this person and his or her family. Palliative care services are helpful not only when a person is approaching death but also during the earlier stages of an illness. Palliative care may be combined with other treatments aimed at reducing or curing the illness, such as chemotherapy. Families also benefit from hospice support when their loved one is dying and after his or her death. Therefore, the goal of hospice palliative care is to improve the quality of life for patients and their families facing problems associated with life-threatening illness.

Community Hospice Care

Community hospice care programs support people in a number of ways. For example, many community hospice programs provide respite services and support groups. What a community hospice program is able to offer can vary from one community to the next. To find out what is available where you live visit Hospice Palliative Care Ontario’s website: http://www.hpco.ca/search/

Residential Hospice Care

Many regions of Ontario now have a hospice for end-of-life care. Often people are cared for at home and then come to hospice for the final two or three weeks of life. Hospice palliative care is aimed at relieving suffering and improving the quality of life for persons who are living with, or dying from, advanced illness or are bereaved. Hospices can be another choice for people at end of life in meeting these needs. Specifically, hospices provide support in the following ways:

  • By understanding and empathizing with the person and their loved ones
  • By being “present” and listening to any needs or issues identified by the person or their loved ones
  • By providing personal care to the person
  • By recognizing signs and symptoms of unmanaged pain
  • By supporting the process of dying and providing care right until the end
  • By providing bereavement support
  • By providing a safe and welcoming space where people can be themselves

Quality hospice palliative care neither hastens death nor prolongs life. The goal of hospice palliative care is to improve the quality of life for patients and their families facing problems associated with life-threatening illness.

Frequently Asked Questions about Hospice Care

What is a residential hospice?
A residential hospice is a free home away from home where people come to live their final days. When a person enters the hospice, it allows their family to hand over all the intricate details associated with pain and symptom management and focus on being a family member, a friend. Care of the family is also a central role of the hospice and has a significant impact on how the family carries on after the loss of their loved one.

How does a community get to have a hospice?
Usually a community must secure all the capital funding itself through donors and volunteer fundraising. That’s exactly how the majority of Ontario’s 40+ residential hospices for end of life care were built…through grassroots, community initiatives.

Do hospices offer other services?
Some hospices offer short term respite care to provide help to a caregiver. Also other examples of other services that some hospices provide include:

  • Day Wellness program
  • Bereavement support groups
  • Prostate cancer support group
  • Senior men’s walking group walk in the gardens
  • Widow to Widow Bereavement Support Group
  • Horticultural Therapy Sessions
  • Suicide Support Group
  • Children’s Bereavement Support Program

Are hospices more expensive to maintain that hospital beds?
No. Hospice care is a proven cost-saving proposition as the daily cost of a hospice bed is about 1/3 that of a hospital bed. Residential hospices do save healthcare dollars while providing people with another choice for end of life care that is often more enriching for all those involved.

Does it cost money to stay at a hospice?
No family will ever pay any money for the care their family member will receive in any of the programs or for their stay at the residential hospice.

Can’t people simply go to the hospital?
Most people wish to die at home in the arms of their loved ones. Often at end of life, families struggle to cope and loved ones are admitted through emergency to hospital beds. Rarely, is this what the patient or the family would have wanted.  

 

1. Read this scenario.

Robyn is a 23 year old recent graduate of the bio-chemistry program at McMaster University. She applied and was accepted to Veterinary Medicine at the University of Guelph beginning next September. Robyn is the eldest in a family of four children who range in age from 16 to 23. At the end of the semester she complained of stomach pains that were very severe. Thinking it was stress, she put off seeing the doctor until she came home for the summer to spend time with her family. At that time she was diagnosed with Stage IV cancer and is at home with her family. Robyn’s mother is a public health nurse who runs the breast cancer awareness program for the public health unit. She is Robyn’s caregiver. As time progresses, Robyn’s parents have been discussing the pros and cons of having Robyn stay at home until the very end of her life.

2. What might those pros and cons be?

Jot down some ideas prior to checking the answer below.

Pros Cons
Robyn may be more comfortable and more at peace than in the hospital Robyn may feel that she is placing a tremendous burden on the family
Robyn may not feel as alone or isolated Robyn’s parents, and siblings may never view their home in the same way again
The hospital routines, and scientific approach to care would not be present at home allowing more time to just be together Robyn’s family may become exhausted in the final weeks
Robyn’s mom is a nurse Although Robyn’s mom is a nurse, Robyn really needs her mom now. Maybe it will be too much for Robyn’s mom to try to be both.
3. How would Robyn’s parents go about getting Robyn admitted to a hospice for her final weeks of life?

Jot down some ideas prior to checking the answer below.

Suggested response:

Robyn’s parents could talk to her primary care physician who could make the call to the local hospice. Some hospices work with their local LHIN and the care coordinators arrange for admission to the hospice. So Robyn’s parents could call their LHIN office. Robyn’s parents could also discuss this idea with the visiting nurse.

 
 

Use these additional resources to learn more about the topic of hospice care.

Here are some videos about hospice care in Ontario to help you better understand what hospice palliative care may do for you or your loved one. http://www.hpco.ca/videos-about-hpc/