Donald Schumacher: Hi! I am Donald Schumacher President and CEO of the National Hospice and Palliative Care Organization. And I am here discussing hospice care. I am going to talk with you now about the hospice services that you could plan to expect if you or a loved will referred to and admitted to hospice care.

Hospice is largely a family focused interdisciplinary model of services that you receive once you are admitted to hospice care. In order to explain this most effectively I thought I might give you an example. Let's just say your physician has determined that in fact a cure is no longer possible and hospice can provide you with as much comfort as possible as you go for the process of the dying.

So what he or she would do, would mention to the patient and the family that they think it's time for a hospice referral. The doctor would call the hospice, would recommend that hospice individual go out and see the patient to assess their appropriateness for hospice care. A nurse would be assigned to come out and visit you and your family to do an assessment of what your needs were, your medical needs, your psychological needs, your spiritual needs, and that she would then, would take that information and go back to the hospice team to talk about what was going on at home, and how this hospice team might craft for you, an individualized, interdisciplinary team that would meet all of your needs to receive hospice services, largely in your own home. Those services would be medical services provided by a physician, the doctor would speak with your current physician, look at all of your medications that you are on, look at your current pain levels, or symptoms of discomfort and assess for you what would be a good reasonable regimen of good pain and symptom management so that you are very, very comfortable. A social worker would take an assessment of what your own psychological or family needs are in terms of looking at the process of your dying. He or she then would go back to the team with recommendations about conversations that could be had with the family to help facilitate the process of dying. If there is a need for a volunteer support occasionally what happens is that family members need get out. So a volunteer would be assigned to come to your home and just sit with the patient, as the family goes about their daily business or attending to things that need to be taken care off outside the home. Your spiritual needs would be addressed as well and a pastoral care person would assist whether or not you had an outside pastoral care person that was providing you with those services, or if you needed a pastoral care team member, to come in and provide you with some spiritual support in your own home. In addition to that the nurses and the team would be assessing whether or not you need a hospital bed, a walker, things that might be necessary to keep you comfortable at home as well.

Very important part of the hospice process is making sure that that there is an assessment is to what the potential bereavement needs would be for the family after the death of the patient. So our bereavement specialist would be in touch with your family as well. And after the death of the patient they would be available to provide bereavement support services to that patient's family for about 13 months after the death of that individual patient.

So this person we are talking about now, their spouse would be available, their children, their friends would have opportunities to receive bereavement support after the process. And sometimes that is the most difficult process of letting the patient go and that is acclimating to the life without them. It helps many patients to know, that after their death their family members will still be taken care of. It's very, very important. So those are the types of hospice care, next let's talk about when to begin the process of a hospice referral.