End of life choices are among the most difficult decisions the individual and/or family will make. Nursing is in an ideal position to assist the patient/family to navigate the challenges of end of life care. Most Medicare/Medicaid Providers of Services like hospitals, nursing homes and hospices are required to provide the patient with information regarding the right to accept or refuse medical care. An informed nurse can encourage the patient to consider the benefits of exercising the right of self-determination in health care matters. Personal health care preferences can be formalized in an advanced directive or other legally enforceable life/end of life planning document.

Some terminal patients may opt to pursue all available curative options including extreme life-sustaining measures. Others may choose to avoid extreme measures if the benefits of treatment are outweighed by a significantly diminished quality of life. Hospice may be an appropriate option for those patients who choose the later.

Hospice is a medically supervised end of life option that promotes quality of life in a patient's last months. Hospice provides patient centered care that includes medical, nursing, psychosocial, and familial support for the terminal patient.

Hospice is still a relatively new health care option in America. It continues to evolve to meet the standards set by the Centers for Medicare & Medicaid Services within the limits of funding authorized by the U.S. Congress. it is important to be familiar with the rules that determine eligibility and the extent of benefits available to the patient as well as the cost and value of the hospice industry. We hope you find this educational offering informative.