The Idaho State Hospice Organization (ISHO), a statewide, non-profit professional organization, is dedicated to promoting and providing access to quality hospice and palliative care for all terminally ill Idahoans and their families. Well-trained, committed professionals and volunteers provide these services to help Idahoans during life's most difficult passage. ISHO has prepared this site to inform the public about hospice and palliative care - what it is, where to access these services, and how individuals and organizations can actively support ISHO in its efforts to promote hospice and palliative care in Idaho. Resources and links to other sites offer further information. Through better educating the public about hospice care, we hope more Idahoans will make use of this valuable service. (For ISHO members, password-protected access to up-to-date educational and professional news is available under ISHO NEWS) What is hospice? Hospice encompasses the whole person… Hospice is a concept of care that values the whole person, fosters the quality of life and assures comfort when cure of disease is no longer feasible. Hospice helps those who are terminally ill and their families to live out the rest of their lives as comfortably and completely as possible. The term is derived from medieval times when hospice was a place of refuge and refreshment for pilgrims on their way to the Holy Land. It came into its current definition in the late 20th century in England, when it was noticed that hospitals and physicians were ill equipped to deal with the emotional and social issues that had to do with terminal illnesses. Their whole focus was cure and treatment of a disease to make a patient well again, not comfort and care for those for whom cure was no longer possible. Many of those who were terminally ill accepted and understood the nature of their disease and their life expectancy. What concerned them most was being able to talk openly about their illness with well-meaning loved ones, or to address some of the more practical issues, such as getting their affairs in order. Dame Cicely Saunders opened St. Christopher's Hospice in Sydenham, England in 1967. A few years later, in 1974, the hospice movement came to the United States. The Connecticut Hospice in New Haven was based on Dame Saunders' model of compassionate care. Hospice offered the terminally ill a way to have their wishes known, reach closure, and die with dignity. Life's final passage was viewed as life's last stage of growth. America's death denying culture makes it hard for us to address and acknowledge the many issues surrounding death, leaving both patients and families bereft and unprepared for what could be a time of coming together and peace. Several years ago a Gallup survey revealed that Americans' greatest fears associated with dying were three: becoming a burden to others, their ability to endure the pain, and dying alone. Nine out of ten said they would prefer to be cared for at home if terminally ill with less than six months to live. Many also expressed a desire to be able to die at home, among familiar surroundings and with loved ones. Caregivers said it took one to two years to adjust to the death of a loved one, yet less than 10 percent of the public ever participate in bereavement counseling. Hospice in America has focused on meeting the physical, emotional, social and spiritual needs of the dying and their families. Today, nearly 95% of all pain is manageable, and patients can be made comfortable to carry on as much as possible with their lives. Hospice also offers practical support to the patient and the family so that the patient remains self-sufficient as long as possible and he or she do not feel their care has overwhelmed those they love. Finally, hospice workers understand the spiritual and emotional needs of those dying, and can often help a dying person to achieve peace and comfort. Today, nearly 25 percent of all those in the USA who die of a terminal illness use the services of hospice. Hospice supports both the patient and caregivers ........ Hospice is a complete program of care provided by healthcare professionals in cooperation with a patient's physician. The approach is a holistic one and the patient and family are viewed as a unit. Care focuses on the physical needs, but also the emotional, psychological, social, spiritual and financial aspects of the terminally ill. These services can include pain management, securing equipment such as beds, wheelchairs, and oxygen, providing respite and information for the caregivers, and supporting families in their bereavement. Examples of some specific services are: - Home and hospital visits by nurses and other healthcare professionals and volunteers - Managing pain and controlling symptoms - Providing medical treatments prescribed by the physician - Assisting in obtaining medical equipment, supplies or medications - Providing or arranging for respite or continuous care - 24 hour, 7 day a week emergency/crisis assistance - Instructing and supervising family members in patient care - Performing personal and household services, such as grocery shopping - Counseling and emotionally supporting family members - Offering spiritual support - Providing companionship and practical services by lay volunteers - Giving information and guidelines regarding financial aid, insurance, in-home support and transportation agencies, community agencies - Lending bereavement support to adults and children - Supplying resources and information about death, dying, grief and loss including information about AIDS, dementia, and cancer Since services do vary by hospice, you are encouraged to contact your local hospice for more detailed information. (See 'Hospice Care in Idaho' for a complete listing of Idaho hospices) Hospice patients are seeking comfort, not cure....... Hospice patients are defined as being terminally ill, no longer seeking active treatment aimed at cure and often having an estimated prognosis of 6 months or less to live. Approximately two-thirds are cancer patients with the balance suffering from AIDS, Alzheimer's Disease, Parkinson's Disease, ALS (Lou Gehrig's Disease), end stage heart and lung disease and other fatal conditions. Many of those admitted to a hospice program are referred by their physicians. Others come on their own, or as referrals from hospitals, local community agencies or from a friend or a relative. In some cases, the patient may not wish to become a hospice patient. Some hospices may, however, still offer help to the patient's family or caregiver. We encourage caregivers in this situation to check with their local hospice. Hospice is an end-of-life treatment that focuses on quality of life and the dignity of the patient.... Hospice is an option available to those who are terminally ill and should be talked about as part of their care. It is not an easy subject to raise, since for many -physicians, patients and caregivers-- it is often very hard to accept that an illness is terminal. Our culture has often been one where death is a taboo subject. We avoid talking about death, often equating discussion to 'giving in' (to the disease) and 'giving up' (hope). There may also be a lack of awareness and education among medical practitioners surrounding pain, symptom control and end-of-life care. Hospice staffs are very sensitive to these issues and are available to help the patient and the family discuss their care options. Hospice care is available to all, with no regard to race, creed, or financial ability.... Generally, hospice care is paid for by private insurance companies, Medicaid and Medicare, and private pay. We also depend upon public and local community support and donations, grants and memorial gifts and fundraising. No one is ever turned away for financial reasons. Hospice is more than any particular place.... Many people think of hospice as a place, or that hospice is only provided at the home. Neither thought is completely correct. Hospice care can be provided wherever the patient is best served and the services are available: at home, in assisted living residences, nursing homes, within hospitals, or at a separate location. Families need to check with their local hospice to find out what arrangements can be made. If care is provided at home, the hospice provider will assess the environment, make recommendations and help acquire any necessary equipment. Often, needs are minimal at first, but then increase as the illness progresses.