Hospice care
Principles of hospice care
Hospice care is comprehensive care for a dying patient, covering physical, psychological, social and spiritual needs. The World Health Organisation (WHO) defines hospice care as part of palliative care, where the aim is to relieve suffering and improve quality of life when curative treatment is no longer available. The central principles of hospice care are respect for the patient's right to self-determination, effective pain and symptom management, support for family members and acceptance of death as a natural part of life.
In Finland, hospice care is guided by Current Care Guidelines, the policies of the Ministry of Social Affairs and Health and the Health Care Act. Every person in Finland has the right to quality hospice care regardless of their place of residence, although there are regional differences in the availability of services in practice.
Hospice care in Finland
Hospice care is provided in Finland in various settings. Specialised hospice homes, such as Terhokoti in Helsinki and Karinakoti in Turku, offer around-the-clock care in a homelike environment. Hospital and health centre wards care for hospice patients, particularly in areas where there are no separate hospice units. Palliative outpatient and consultation services support the provision of hospice care.
Home hospice care is a growing form of care in which a multidisciplinary team – doctor, nurse, social worker and, if necessary, chaplain – supports the patient and family members at home. Many patients wish to die at home, and home hospice care makes this possible. The team is reachable around the clock, and if necessary the patient can be transferred to an inpatient ward.
Patient's rights and advance directive
A hospice patient has a legally guaranteed right to participate in decisions about their care. An advance directive is a document in which a person expresses in advance their wishes for end-of-life care. It may include a wish to forgo life-sustaining treatments, to intensify pain medication or regarding the place of care. A continuing power of attorney enables the appointment of a representative for decision-making if the patient can no longer express their wishes.
The patient has the right to adequate pain management. In hospice care, strong pain medication, such as opioids, is used when needed, and the fear of addiction is not an obstacle to effective pain management at the end of life. Other symptoms – breathlessness, nausea, anxiety and restlessness – are also actively treated.
Supporting family members
Hospice care is directed not only at the patient but also at the family. Family members are supported during the loved one's illness and after death. In hospice units, family members can participate in care and spend time with the patient without restriction. Social workers and chaplains offer conversation support. After death, family members are offered grief conversations and directed to grief work support services as needed. Anticipatory grief is a natural part of the hospice phase, and recognising it helps family members receive support in good time.
Frequently asked questions
How does hospice care differ from palliative care?
Palliative care is a broader concept that covers symptomatic treatment of a patient with an incurable illness throughout the course of the disease. Hospice care is the final phase of palliative care, which begins when death is expected within the coming days or weeks. Hospice care focuses particularly on the comprehensive support of the dying person and their family.
Who decides on starting hospice care?
The hospice care decision is made by the treating physician together with the patient. The decision is based on a medical assessment that the illness has progressed to a stage where curative treatment is no longer beneficial. The patient has the right to participate in care decisions and refuse treatments. An advance directive and continuing power of attorney support the fulfilment of the patient's wishes.
Where is hospice care provided in Finland?
Hospice care is provided in hospital wards, health centre wards, palliative care units, hospice homes (such as Terhokoti in Helsinki and Karinakoti in Turku) and in home hospice care. Home hospice care is a growing form of care in which a hospice care team supports the patient and family members at home. The availability of care varies by region.
What does hospice care cost the patient?
In public healthcare, hospice care falls within the care guarantee and standard healthcare client fees are charged. A daily ward care fee is charged for inpatient care, up to the maximum set by the Client Fees Act. Client fees have an annual payment ceiling. In private hospice homes, costs may be higher.
Related terms
A person's advance declaration of their wishes regarding their own medical care in a situation where they cannot express their opinion.
A power of attorney prepared in advance by which a person authorizes another to manage their affairs if they become incapable.
A grief experience that begins before a loved one's death, typically in connection with a serious illness or progressive memory disorder.
A notice published in a newspaper or online announcing a person's death, containing basic information about the deceased and the funeral.
Read also
Comprehensive guide to grief support services in Finland: crisis helpline, peer support groups, parish and organisation support for the bereaved.
Guide to making an advance directive (hoitotahto) in Finland. Learn what a living will covers, its legal standing, and how to ensure your end-of-life wishes are respected.