As people in South Carolina and the rest of the country live longer, hospice has been called on more often to serve an aging population.
Hospice service more than tripled in the past 10 years in South Carolina. Fewer than 7,000 patients in South Carolina used hospice in 1997, while more than 21,000 people had hospice care in 2007.
The need for hospice continues to grow. The number of hospice providers in the past two decades has shot up more than 600 percent. In the early 1990s, 11 organizations offered hospice care in South Carolina, said Tamra West, director for S.C. Programs for the Carolinas Center for Hospice and End of Life Care, the trade association for most hospices in the state. Currently, 67 organizations offer care in 91 sites around the state, West said.
However, even with a population getting older and living longer, potential federal budget cuts in the works in Washington could slash the dollars -- mainly Medicare payments -- that pay for hospice care, said both West and Jane Armstrong, executive director of Hospice & Community Care in Rock Hill.
Moreover, hospice providers face the same shortage of nurses and other skilled medical staff that are problems in all areas of health care, the experts said.
A need for hospice does not mean the patient is dying or will die within days or even weeks, say hospice experts and caregivers. But a doctor must certify there is a medical reason for hospice to be called in.
"In general, hospice provides care to people with incurable illnesses," Armstrong said.
Most patients are going to die within six months to a year, West said, but there is no set timetable for hospice to assist a family. Some patients who have hospice services eventually recover.
Most times, the patient is in a chronic stage of disease and there is no aggressive treatment going on, said Amanda Werts, executive director of Agape Community Hospice of The Piedmont in Rock Hill.
Hospice care is provided mainly at the patient's home, but also is provided at "hospice houses" or "respite houses" and in nursing homes.
The money to pay for hospice care in almost all cases is paid for by Medicare, Medicaid or private insurance, West said.
In South Carolina in 2007, Medicare paid for 89 percent of state hospice care, Medicaid paid for 5 percent and private insurance paid for 3 percent, according to state statistics.
Some hospices offer care for indigent patients with no insurance.
Hospices can be for-profit or not-for-profit. All face the same state licensing and regulation requirements, said Thom Berry, spokesman for the S.C. Department of Health and Environmental Control.
All hospices in the state are licensed and regulated by DHEC. Hospices are inspected annually and any time there is a complaint, Berry said.
No hospices in York, Chester or Lancaster counties are under any disciplinary action by the state, Berry said.