WEST PALM BEACH, Fla. — November is National Hospice Month. I was introduced to the hospice movement when, as a junior at Georgetown University in the late 1970s I volunteered at a hospice in Washington.

Little did I know that what was a fledgling concept 30 years ago was destined to become a mainstay of treating the terminally ill in the 21st century.

The hospice movement was founded in England to help cancer patients "die with dignity." More specifically, hospice care was conceived as a way for terminally ill patients to plan the end of their life. Everything from pain management to funeral plans falls under the umbrella of hospice care. Dying at home surrounded by family is central to the concept. In-patient facilities do exist, but hospice care is designed to take place at home.

Letting patients control their death is a new concept for most of us. In order to do so, most hospices help to compose a document called an Advanced Directive. Advanced Directives spell out the patient's wishes in detail, thereby ensuring that the patient is treated as they want and avoiding family disagreements and misunderstandings when the patient is no longer able to communicate their needs.

Hospice is not intended as a place to send patients when death is imminent. However, in America, many people are still not comfortable watching a loved one die at home. Our inpatient facilities often turn into a place where families bring their loved one to die. Once the patient has died, hospice stays involved, offering bereavement counseling and long-term support.

When hospice is used as intended, it makes an enormous difference in the death experience, both for patient and family.

A hospice referral should be made when the patient has less than six months to live in the best estimation of the doctor. Unfortunately, the average hospice stay is less than a few weeks. It is almost impossible to do the work necessary to prepare both patient and family in such a short time.

If all of us work to make hospice care the norm, it will be a win-win health care option: It will provide better care at a lower cost and bring families together when they need it most.

Dr. Melanie Bone is a cancer survivor and gynecologist who practices in West Palm Beach. Send questions about cancer for her column to info@drmelaniebone.com. Any questions submitted will be considered for her column.

Distributed by New York Times News Service