Hospice one of few examples of health care that works | Opinion

What matters to you most at the end of life?

The answer to that question is different for each person. But what an important question it is.

I have the privilege and responsibility of overseeing the delivery of end-of-life care that meets each person’s unique needs and wishes, including medical, spiritual and emotional support. There is a term for this in the medical community – “coordinated care” – the origin of which can be traced back to the beginnings of the hospice movement more than 50 years ago.

I was fortunate enough to be mentored by one of the pioneers of hospice care in America, Florence Wald. Florence and her compatriots recognized that quality care at the end of life is a very unique and personalized endeavor that requires a comprehensive, coordinated approach, based on the needs and wishes of the patient.  Our commitment to this philosophy is what makes hospice a care model unlike any other in our country’s healthcare system. It’s a special kind of care – and it’s a model that works.  

Yet the concept of hospice remains amorphous for many people. Is it a place?  Yes, it can be. Do you have to be in a hospital to get hospice? No. You can be at home and the hospice care team will come to you. So is it just a home health service? No.  That can be part of it, but hospice is so much more.  

The Medicare Hospice Benefit delivers individualized care and services based on what the patient wants at the end of life. And what does the patient want? To determine this, hospice providers work with the patient and family to identify needs and implement an integrative approach to care that seeks to maximize a person’s quality of life.

For many, it is nursing care and pain management, but we also provide emotional and spiritual care. Some patients benefit from acupuncture, massage, music or art therapy — all of which have resulted in excellent outcomes. We can also provide a connection to spiritual leaders or a member of the clergy for patients who find comfort there. We even recruit and train volunteers to help care for patient’s pets as part of our Pet Peace of Mind program.

As part of this holistic approach, we also care for family members.  

Hospice provides respite care and bereavement counseling as part of the Medicare Hospice Benefit. We work with families and caregivers to educate them about how to meet the special needs of their loved ones at this point in life’s journey.  As I learned with my own mother, it can be empowering for adult children, spouses and family friends to be helpful in this process and contribute to the comfort and care as the person they love approaches the end of life.

And this is what we mean by coordinated care: a group of providers who bring a special expertise to ensure the whole patient is cared for.

Across Florida alone, more than 120,000 Medicare beneficiaries elect to receive hospice care annually and 57 percent of beneficiaries pass away while under the care of a hospice provider, underscoring the critical importance of this benefit to older Floridians and their families.

Although “coordinated care” models today are largely evaluated through the lens of metrics like reduced hospital readmissions and decreased health complications, hospice’s success is very different. While it achieves both of those objectives under the “cost-effective” healthcare gauge, what hospice does physically, emotionally and spiritually for the patient and family is where its real worth lies.

Success in hospice care means that at the end of their lives individuals under our care never feel alone; that their bodies are comforted, and their spirits uplifted. Under the tutelage of Florence, I learned hospice is about approaching patients with openness, providing heartfelt care and uplifting the spirit.

In an increasingly fragmented and broken healthcare system, hospice is one of the few examples how healthcare can – and should – work.  It is coordinated care at its best – and it’s an important model for the future of our nation’s healthcare system.

Rafael J. Sciullo is the president and CEO of Empath Health and Suncoast Hospice in Clearwater.