Eighty percent of Americans would prefer to die at home but as data from the Stanford School of Medicine makes clear, this doesn’t always happen. On average, just 20 percent remain at home while the majority (60 percent) face end-of-life in acute care hospitals.1
Pandemic pressures, however, are changing these percentages as patients worry that hospital or nursing home stays could separate them from their families at a critical moment in their care. The result is a substantive uptick in the demand for hospice care at home. Some care providers are now seeing 30 to 40 percent increases in the demand for home-based services.2
But what is home hospice care? How does it differ from facility-based care, and what advantages does it offer?
What is Hospice Care at Home?
According to the National Institute of Health (NIH), hospice care typically takes one of two forms: at home or in a care facility. The intent remains the same – to provide patient-centered care for an individual in their last days of life. While this means the stoppage of efforts to cure certain current conditions, it doesn’t mean the removal of all treatment. Instead, treatment is centered around providing the patient as much peace and comfort as possible.3
In a home-based hospice approach, family members take on care responsibilities, but in addition, patients are also cared for by a diverse team of specialists including doctors, nurses, and spiritual counselors. Along with scheduled visits from specific providers, patients and their families typically have access to a 24/7 contact in case of an emergency.
How Does Home Hospice Care Differ From Facility-Based Care?
The biggest differences between home and facility hospice care are familiarity and flexibility. Facilities are purpose-built to serve hospice needs, but the move from home to hospice care is sometimes stressful for patients who may have lived in their current home for decades.
And where hospice facilities may have more rigid scheduling to ensure patient needs are addressed in a timely fashion, in-home care allows for flexibility in specialist and check-up appointments. Many hospice care providers now employ a variety of trained staff who coordinate their schedules using cloud-based hospice software, which in turn allows patients and their families to get care when it works for them.
Key Advantages of In-Home Hospice Care
The shift to hospice home care offers two key advantages: comfort and compassion.
As noted by the New England Journal of Medicine (NEJM), patient-centered care “focuses on physical comfort as well as emotional well-being.”4 At home, patients are surrounded by things that make them comfortable — their own bed, familiar floorplans, pictures, and mementos and cherished pets — thus allowing providers to focus on issues related to end-of-life care, rather than bridging emotional gaps created by sudden life upheavals.
Compassion is also critical. A recent study published in the BMC Palliative Care Journal identified four key dimensions of compassion in care: relational, dispositional, situational, and active.5 In practice, this requires caregivers to cultivate relationships with patients that reflect a disposition of honesty and acceptance, are based on current context, and are demonstrated through specific action.
Home hospice care empowers this process building by allowing hospice providers to interact with patients one-on-one in spaces they’re comfortable with and laying the foundation for compassionate connections. As so, hospice industry trends are shifting toward a home-based model as families and patients prioritize the familiar and flexible for end-of-life experiences.
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Best Practices to Eliminate Compliance Gaps in Hospices
1 Stanford School of Medicine, “Where do Americans Die?”, 2021.
2 AP News, “In Pandemic, More People Choose to Die at Home,” February 7, 2021.
3 NIH, “What are Palliative Care and Hospice Care?” May 14, 2021.
4 NEJM, “What is Patient-Centered Care?” January 1, 2017.
5 BMC Palliative Care, “A Pattern Language of Compassion in Intensive Care and Palliative Care Contexts,” February 2, 2019.