Communication Strategies — Publicizing Hospice Care

July-August 2004


Ms. Weiss is a Santa Monica, CA–based health care consultant and speaker.

Each year, one out of every two Americans experiences the death of a close friend or relative.

Because this is so, Sr. Francine Gries, OSF, executive director, St. Francis Hospice, Honolulu, HI, understands that death and dying are sensitive issues for many people. A 1996 Gallup poll done for the National Hospice Organization found that the greatest fear associated with the end of life is "being a burden to family and friends."

"Because many do not wish to discuss death issues, especially when death is not imminent, people tend to be unfamiliar with hospice," Sr. Francine says. "One of hospice care's many roles is to help people come to terms with mortality and to consider how they would like to be treated at life's end."

The nation's 3,000 hospice programs, 25,000 hospice professionals, and more than 100,000 hospice volunteers are committed to helping the terminally ill live their final days with dignity, fearing neither pain nor being alone, in the warmth and comfort of an environment they have themselves chosen, and surrounded by family and friends.

"We accept death as a natural part of life and seek neither to hasten nor prolong the dying process," says Sr. Francine. St. Francis Hospice's census is typically around 120 people, including some three dozen patients who live either in a converted mansion or a newer, specially constructed hospice facility (both on the island of Oahu); the remainder receive care in their homes or in hospitals or long-term care centers. Over the past 25 years, St. Francis has served 25,000 terminally ill patients, providing them with a continuum of care for medical, emotional, social, and spiritual needs. For friends and family members the hospice offers bereavement counseling, support groups, and memorial services.

Families that take advantage of hospice services typically rate them more highly than they do medical, hospital, or other health related services. To increase awareness of their services, many hospice organizations are beginning to implement communication techniques.

Health Professionals
End-of-life care and hospice principles are increasingly being taught in medical schools, seminaries, social work departments, and training in case management, dietary practices, and related disciplines. Some such courses are taught by school faculty, whereas others are taught by hospice professionals. Some hospice organizations offer internships or clinical rotations.

Because hospice organizations know that most referrals come from health care professionals, they increasingly promote their services in hospitals and health care facilities, by means of newsletter articles, continuing education programs, employee orientation presentations, and lectures to volunteers, and through enlisting the participation of health care workers in hospice visits.

Hospice organizations often encourage their medical directors and physician "champions" to institute dialogues with other doctors concerning the importance of timely hospice referrals. These physician-advocates also write articles for professional journals and newsletters emphasizing hospice's expertise in pain and symptom management and the overall value of palliative care. Hospice organizations also share with physicians and other caregivers of terminally ill patients the letters they receive from family members who have had hospice experience.

Hospice physicians also share their expertise through participation in cancer treatment planning conferences (sometimes called "tumor boards"), in which cancer specialists review each other's cases. (About two-thirds of hospice patients have cancer.) These conferences focus on treatment; still, it is helpful for specialists to be able to explain end-of-life care to patients who will need it.

Hospice organizations also try to educate employees in doctors' offices about hospice care and ways to make referrals to it. This makes sense because patients and their families often place a good deal of trust in such people. (These physicians may also allow hospices to place literature in their offices.)

The primary task of hospice volunteers is to assist its staff and its patients and their family members. But they can play other roles as well, such as promoting the hospice concept among community groups, religious organizations, and in their regular places of employment.

Volunteers can also raise funds for the hospice. In addition, they might ask florists and greenhouse owners to contribute flowers and plants to brighten the environments of hospice patients.

Employers often report difficulties in dealing with employees whose loved ones are dying. Hospice organizations can offer workplace programs on death, dying, and grieving to businesses and unions. In addition, they can provide articles to company newsletters concerning end-of-life care, the Medicare hospice benefit, caring for a loved one, and related issues.

To increase understanding of death and dying (and lessen fear of it), some hospice organizations make presentations to schools, community organizations, long-term care facilities, senior citizen programs, and religious groups. Speakers are sometimes accompanied by surviving friends or family members who provide testimonials to hospice care.

Some hospice organizations have worked with local restaurant owners and florists to provide patients with special, flower-bedecked candlelight dinners served by volunteers. Others have encouraged local libraries (including online libraries) and video stores to stock materials on hospice and end-of-life care. Still others have organized patient/family art exhibits, Christmas tree-lighting ceremonies using ornaments in honor of deceased loved ones, and the sewing of hospice quilts.

Hospice organizations should consider using public media to increase awareness of end-of-life care. This can be done through writing newspaper, newsletter, and electronic articles; newspaper editorials; letters to the editor; participation in public affairs meetings and radio talk shows; and by calling in to talk shows.

Spreading Knowledge
As Sr. Francine notes, "While hospices around the world care for millions of people each year, they could provide care for many, many more if physicians, other health professionals, and the community were more knowledgeable about the difference we make in dying people's lives. Hospice reminds us that how our days end is as important as how our days are lived."

For more information on St. Francis Hospice access their website. Rhoda Weiss, recipient of a Kellogg Foundation fellowship to study hospice, can be reached at 310-393-5183.


Copyright © 2004 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Communication Strategies - Publicizing Hospice Care

Copyright © 2004 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.