Medical Directors Corner

The purpose of hospice is to provide “comfort care” (Palliative Care) to people who have an incurable disease which, under usual circumstances, will lead to their dying within six months of being admitted to hospice.

Medicare requires that the medical director be responsible for the quality of “comfort care” provided by the hospice and their plan of care for each patient (which includes the control of symptoms such as pain) regardless where that patient resides – a home, a nursing home, or assisted living facility.
The medical director meets these obligations by supporting the hospice staff in their role of “comfort caregivers”; and by:

  • being knowledgeable in symptom management;
  • being available to the staff 24 hrs a day, seven days a week;
  • visiting patients in their homes and recommending treatments, when necessary;
  • educating patients and their families during home visits;
  • educating staff through in-services and during individual patient discussions;
  • communicating with the patient’s primary physician.

Many people (patients, families, physicians) are uncomfortable talking about dying. One of the most important things I can do is to help overcome that discomfort by bringing such discussions into the open, in a compassionate and caring manner; and by helping people understand what is a “natural” way to die and what are myths of end-of-life care.

Three or four generations ago, grandmothers knew how to care for the dying. Technology and hospitals have taken over this and hospice is trying to take us back to a forgotten skill and help us to die peacefully at home.

I will be adding educational pages at regular intervals to hopefully help patients, their families, and professionals, understand what is considered good end-of-life care within the Palliative Medicine field, so that everyone can make better informed decisions.

Robert J. Webb, MD