Hospice is about living, about giving people access to what they need so they will have the best possible quality of life during a difficult time. Patients who choose hospice have made the decision — along with their doctor and family — to change cure goals to comfort goals. That is, they are opting for palliative, or comfort, care. Therefore, the main medical intervention is symptom management, including pain control. Because pain can be experienced on many levels — physical, mental, emotional, and spiritual — the hospice team may intervene in any of these areas.
The "unit of care" in hospice is the patient and their loved ones, meaning that hospice cares for both the dying person and their family with a range of services. In addition, the family continues to receive help after the patient dies.
Many people mistakenly associate hospice only with sorrow. However, most hospice experiences include times of joy and peace and heartwarming closeness. People often comment that hospice experiences, although involving a death, give them a deeper understanding of life.
Hope and healing are always present in Hospice care. Healing may mean not the remission of cancer, but the resolution of distress in the family before death occurs. Or healing may mean that a certain symptom is controlled. A person may be seeking a cure for their spirit with the knowledge that they probably will not find a cure for their body.
Hospice never takes hope away. Hope may be a wish to see a friend or loved one who is traveling a great distance to be at the patient's side. Hope may be for comfort and peace for the patient, family and loved ones — both physically and spiritually.
After studying and visiting hospice care facilities abroad, Gainesville physician, Dr. Raymond Fitzpatrick, decided it was time to bring home specialized, comprehensive care to patients and families facing terminal illness in our back yard.
In 1979, around the same time that hospice care was introduced in our country, Dr. Fitzpatrick, along with the commitment of the then Administrator of Alachua General Hospital (AGH), Edward C. Peddie, and the President of the AGH Auxiliary, Alice Sharp, ensured the accomplishment of that goal. With a $10,000 donation from the AGH auxiliary, five auxilians, and a part-time nurse-administrator, North Central Florida Hospice, Inc. d/b/a Hospice of North Central Florida (HNCF) was born.
Hospice patients--who at the time were primarily cancer patients--received free medical care for five years, as a service to the Alachua County community by AGH.
In 1980, the Florida legislature approved the first Hospice Licensure Law that was later used as the framework for the Federal Medicare Hospice Benefit. HNCF staff and volunteers provided testimony in Tallahassee to ensure the passing of that law. Also that year, HNCF received a license and a Certificate of Need (CON) to serve Alachua, Bradford, Columbia, Union, Dixie, Gilchrist, Levy and Putnam Counties. Five years later a CON was granted for Suwannee, Hamilton and Lafayette Counties resulting in a service area of approximately 7,000 sq. miles--roughly the size of Massachusetts.
From humble beginnings sprang a commitment to provide the best possible care anywhere to dying people and their family members without regard to diagnosis, age, sex, place of residence, religion, or ability to pay.
That commitment continues today. Hospice of North Central Florida staff and volunteers are available 24 hours a day, 7 days a week, no matter where someone lives or the type of insurance they do or do not have. With over 200 staff members and more than 800 volunteers, nearly 2,000 dying people and their families will be served by HNCF this year.
Hospice of North Central Florida was accredited by the Joint Commission for the Accreditation of Hospitals (JCAHO) in 1987 and 1990. HNCF serves the largest rural area in Florida and in the country and is one of 40 of the largest hospices (according to patients served) in the United States.
HNCF offers not only traditional hospice care consisting of nursing, social work, spiritual care, and volunteer services, but also children's services, bereavement "Life After Loss" programs, care of people with AIDS, multilingual staff, Community Speakers Bureau, and a Bridges Program which helps locate community resources for terminally ill patients who are not ready for the Hospice program.
In 1992, a need was identified for those people living alone--without caregivers. Everyone should be entitled to a full measure of dignity and choice no matter what their situation and terminally ill patients with no one to take care of them were no exception. With the generosity and encouragement of Hospice Board Member Laura Carmichael, a long-term resident of Gainesville, the Hospice House Care Center was born.
The Hospice House, completed November 1996, created a new dimension to Hospice of North Central Florida's services providing a home away from home for patients without a caregiver or whose care requires constant attention.
The Hospice House neither appears nor functions like a hospital or nursing home, yet it has all the professional staff, volunteers and equipment necessary for professional palliative care and other services for the terminally ill and their loved ones.