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Senior Planning

How Hospice Care Supports the End-of life Journey


By Maria Rivera


Hospice care focuses on the quality of one’s life as they embark on the end-of-life journey. It is not about dying. Instead, hospice affirms life, neither hastening nor postponing death.

The goal of hospice care is to provide patients with comfort and symptom management to help them find peace and meaning in the final months or weeks of their lives. At Hospice of the Fisher Home, we focus on quality of life, and this guides everything we do to support patients and their families.

Managing terminal illness can feel overwhelming. A hospice care team provides support to patients and their families through a delicate and challenging time using a comprehensive care model.

Maria Rivera

Maria Rivera

“Hospice helps people to live the best life they possibly can up until their very last day.”

The hospice team forms a safety net for the patient and the family. The medical director, nurses, and CNAs are experts in comfort care. They manage pain and symptoms so that patients can live as fully and comfortably as possible.

Spiritual and bereavement counselors meet with patients and their loved ones to guide them through the emotional and social challenges that often arise at the end of life. Social workers assist with social and emotional issues. Volunteers offer support in various ways, including massage, harp, and other live music, as well as therapy dogs, Reiki, acupuncture, meditation, reading books, and sitting vigil. Each member of the team has specialized hospice training and a deep dedication to helping patients and their families experience peace, comfort, and happiness.

Hospice helps people to live the best life they possibly can up until their very last day. For some people, that may mean feeling good enough to float in the pool at the local YMCA, spend a few hours fishing with a friend, or have their favorite dish for dinner and a big helping of dessert.

Educating people about the benefits of early hospice admission is important. Because hospice care focuses on the well-being of the whole patient — physical, mental, emotional, and spiritual — earlier admission to hospice means the patient can experience more quality time with loved ones. There is also a greater opportunity to contemplate what matters most in life when the patient is comfortable and experiences less stress and anxiety during their final months.

When caregivers and providers are aware of the benefits of hospice, they can facilitate early admission. It’s important to plan for these difficult decisions, put preferences in writing, and have conversations about the care you want for the end of life.


Maria Rivera, BSN, RN, is executive director of Hospice of the Fisher Home in Amherst, the only independent, nonprofit hospice in Western Mass., providing end-of-life care at a nine-bed residence in Amherst and visiting private residences, assisted-living facilities, and retirement communities throughout Hampshire, Franklin, and Hampden counties. It also provides hospice care to veterans at the Veterans’ Home in Holyoke.

Senior Planning

It’s Not About Giving Up, but About Quality of Life


There may come a time when efforts to cure or slow an illness are not working and may be more harmful than helpful. If that time comes, you should know there’s a type of palliative care — called hospice — that can help ensure your final months of life are as good and fulfilling as they can be for you and your loved ones.

Hospice is not about giving up. It’s about giving you comfort, control, dignity, and quality of life.

Insurers, Medicare, and Medicaid will generally provide coverage for hospice care if your doctors determine you likely have six months (a year in some cases) or less to live if your illness follows its normal course.

“Requesting hospice care is a personal decision, but it’s important to understand that, at a certain point, doing ‘everything possible’ may no longer be helping you. Sometimes the burdens of a treatment outweigh the benefits.”

So, how do you know when it’s time for hospice care? Requesting hospice care is a personal decision, but it’s important to understand that, at a certain point, doing ‘everything possible’ may no longer be helping you. Sometimes the burdens of a treatment outweigh the benefits. For instance, treatment might give you another month of life but make you feel too ill to enjoy that time. Palliative doctors can help you assess the advantages and disadvantages of specific treatments.

Unfortunately, most people don’t receive hospice care until the final weeks or even days of life, possibly missing out on months of quality time. This may be out of fear that choosing hospice means losing out on a chance for a cure. Sometimes doctors fear their patients will feel abandoned if they suggest hospice.

Hospice care can help you continue treatments that are maintaining or improving your quality of life. If your illness improves, you can leave hospice care at any time and return if and when you choose to.

The following are some signs that you may experience better quality of life with hospice care:

• You’ve made several trips to the emergency room, and your condition has been stabilized, but your illness continues to progress.

• You’ve been admitted to the hospital several times within the last year with the same symptoms.

• You wish to remain at home, rather than spend time in the hospital.

• You are no longer receiving treatments to cure your disease.

Hospice care can free you up to ensure a time of personal growth and that you get the most you can out of your time left, allowing you to reflect on your life; heal emotional wounds and reconnect with a loved one with whom you have been estranged; visit favorite places or those with special meaning, such as a school, house, or location with a beautiful view you’ve always loved; put your financial affairs in order; create a legacy, such as a journal, artwork, or a videotaped message; or simply be with the people you love and who love you.

There are other benefits of hospice care, too:

• Hospice care allows you to remain and receive medical care in your own home, if desired and possible.

• It prevents or reduces trips to the emergency room for aggressive care that you might not want. Although you still might go to the hospital for tests or treatments, hospice allows you and your loved ones to remain in control of your care.

• Members of the hospice team can clean, cook, or do other chores, giving your loved ones a chance to run errands, go out to dinner, take a walk, or nap.

• Hospice programs offer bereavement counseling for your loved ones, often for up to a year.

Hospice care may not be appropriate if you are seeking treatments intended to cure your illness. Whether receiving hospice or palliative care, you should make a plan to live well so that your wishes for care and living are known.