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A Brief History of Hospice Care and Palliative Care in the U.S. and Oklahoma

04/20/2021

It’s a subject that isn’t easy to think about, but for every one of us, there comes a point when life must come to an end. Perhaps because it's a scary topic, most people aren't aware of the choices available to them and their loved one until they are in middle of dealing with a life-limiting illness.

For people today, there are several approaches to deal with pain, chronic health issues, and complex diseases that may, or may not, get progressively worse. Two important care methods in these scenarios are hospice and palliative care. 

Palliative Care

Palliative care offers pain and symptom management for people of any age and at any stage in a serious, chronic illness. The focus of palliative care is symptom management to help the patient be the most functional and help him or her achieve the best possible quality of life. 

People choose palliative care for such conditions as heart, lung, liver or kidney disease, as well as cancer and many other conditions. With palliative care, patients can continue to undergo treatments that may cure or reverse the effects of their illness by helping get pain and symptoms under control. In addition, family and caregivers receive support and education to help offset the stress of dealing with serious illness.

Hospice Care

Hospice care is a specific type of palliative care, regulated by Medicare, for patients who have six months or less to live. Hospice care is appropriate when the focus of treatment becomes comfort instead of curative. When curative treatment is no longer available, hospice can be a beneficial care option for patients and a tremendous source of emotional and physical support for their families.

Hospice services don’t automatically end at six months. Some people in hospice care live much longer. Medicare, for instance, continues to provide hospice coverage after six months, if the patient’s doctor re-certifies that the patient is terminally ill.

Hospice is not just for elderly patients. Children receive hospice care, as do patients with any end-stage chronic illness, as well as those with progressive degenerative diseases like Alzheimer’s disease, Parkinson’s disease, ALS and more.

Hospice's goal is to make the patient as comfortable as possible, by focusing on three related aspects: the physical, emotional and spiritual well-being of the patient. Hospice counseling also helps patients and families come to terms with the process and gives them a support network.

Despite these benefits, many people still have the misconception that you come to hospice at the very end of a person’s life. But patients don't have to wait until their final week or days of life to choose hospice care. Instead, hospice experts urge families to discuss end-of-life issues well in advance, while an ill person can still state his or her wishes. And sometimes it’s not the patient delaying that choice but instead, the family who “isn’t ready” to select that option.

Hospice is not just a place. Although INTEGRIS Health has The Hospice House, which is a 12-bed in-patient facility available when pain or other distressing symptoms cannot be managed at home, or when hospitalized patients transition into end-of-life care, patients can also receive hospice care in their own homes, the home of a loved one, or in a nursing home, assisted living, or other long-term care facility. 

The Hospice Philosophy of Care: A Team Approach

A hospice patient is treated by a team of people. The team includes not only the patient’s family members, but also a doctor, a nurse, a social worker, a chaplain, home health aides and trained volunteers. An individual plan of care is developed by the team and evaluated regularly to assure quality care is provided. The goal is to control pain and symptoms so that the patient is comfortable, and the family is comforted. 

Typically, this team provides skilled nursing care, patient and family social services, spiritual care, pain control and symptom management, medical equipment and medications, personal care and light housekeeping. The team also helps the family through the grieving process and provides bereavement follow-up for 12 months. Companionship, practical help and family relief are provided by volunteers.

How the Idea of Hospice Care Spread to the U.S.

The concept of providing specialized care for dying patients, linking pain and symptom control with compassionate care, began in England in the 1950’s, when a pioneering physician named Dame Cicely Saunders created the first modern hospice there in 1967.

Hospice care found widespread use in the U.S. in the last four decades. The ideas popular in U.K. began taking root here in the U.S. when physician Dr. Elisabeth Kubler-Ross interviewed 500 dying patients for a book she published in 1969, called “On Death and Dying,” which went on to become an international bestseller. In the book, she made a plea for home care as opposed to treatment in an institutional setting and argued that patients should have the ability to participate in that decision-making. 

Locally, an oncologist named Dr. James Hampton had noted that patients who did not respond to chemotherapy were essentially abandoned by the medical profession at large. He was compelled to make life as comfortable as possible for his terminally ill patients. To learn more, Dr. Hampton visited Dame Cicely Saunders’ hospice in England in 1978 and was subsequently inspired to initiate hospice care for Oklahomans.

Dr. Hampton helped found Hospice of Central Oklahoma in 1980, which evolved as the U.S. legislature enacted a Medicare hospice benefit and certification process. 

In 1990, Dr. Hampton and other physicians from the Oklahoma County Medical Society launched Hospice of Oklahoma County, a Medicare-certified hospice. The organization opened an office in the Mayfair Center on NW 48th Street in Oklahoma City that year. 

Five years later, Hospice of Oklahoma County became an affiliate of INTEGRIS Health. In 2009, it also began operating an inpatient hospice unit called The INTEGRIS Hospice House, which is the only in-patient hospice provider in Oklahoma.

Now, an estimated 1.6 million Americans receive hospice care each year, according to the National Hospice and Palliative Care Organization. 

To Learn More

Whether your loved one needs in-home hospice care or prefers to be in a hospice facility, INTEGRIS Health Hospice Services can meet your hospice needs. We also offer support to the families of our patients through short-term respite care when caregivers need a break, as well as ongoing bereavement and grief-recovery support groups.

To learn more, visit INTEGRIS Hospice Services.

 

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