Is Hospice Care Appropriate for Your Patient? 7 Things to Consider
December 9, 2015
Making the decision to refer a patient to hospice care is never easy. With the family by their side, willing them through their ailments, you always hope to have an optimistic prognosis. But unfortunately, that’s not always the case.
A seemingly irreversible public stigma makes it even more difficult to even mention hospice to a patient’s loved ones, much less suggest it. “End-of-life care” is often misinterpreted as a death sentence, which makes it understandable that families view hospice as a last resort. What most people don’t realize, though, is that hospice is the most compassionate, comforting, and emotionally encouraging form of care for an individual with a life-threatening diagnosis.
When is it time to start considering hospice? The answer is different for every patient, but here are 7 questions that will help you come to a conclusion.
Are You Seeing an Overall Decline?
With patients who are seriously ill, the day-to-day ups and downs can make it difficult to gauge their status. You must take a step back and consider the patient’s health over the past few months (or weeks, depending on the seriousness of their complications), to get a clear picture of their outlook. The patient is either recovering, or they’re in decline. If they’re the latter, the diagnosis becomes terminal, and the possibility of hospice should begin to enter your mind.
Is There an Increase in Pain?
The primary goal of hospice is to ease a patient’s pain and improve their quality of life, whereas aggressive, curative treatment can sometimes bring added discomfort. When a patient with a life-threatening illness is experiencing frequent, increased, uncontrolled pain, it’s time to discuss hospice with the family.
Are They Losing Weight?
Progressive, noticeable weight loss usually signals an impending decline in health. When a terminal illness is accompanied by the inability to eat, many people don’t understand this sad truth: the patient’s health doesn’t decline because they’re not eating; they’re not eating because their health is declining.
Are They Bedbound?
Often alongside weight loss, excessive sleep can be an early indicator of the dying process. As their health diminishes, a patient will typically show decreased energy to the point where they might be asleep more than they are awake. They will also become more difficult to wake from their sleep, and their periods of alertness will become shorter. A patient who has been bedbound for an extended period of time, and will remain bedbound for the foreseeable future, is likely a candidate for hospice.
Do They Qualify?
The Medicare hospice eligibility requirements serve as guidelines not just for referring patients to hospice, but also for evaluating their condition. In order for a patient to be eligible for hospice under Medicare, they must have a terminal illness with a prognosis of six months or less to live if the disease or illness runs its normal course. There are also different qualifications for different illnesses.
Would You Be Surprised if They Died in Six Months?
Diagnosis, prognosis, and resources aside, there is a human element to determining a patient’s outlook. When you see and communicate with them, what is your gut feeling? Referring back to the eligibility requirements, would you be surprised if the patient died within six months? If the answer is, “No,” referring them to hospice can help minimize any suffering they might encounter in their final days.
Is the Family Emotionally Ready?
Any situation that involves the possibility of hospice brings with it a deluge of grief, anxiety, sadness, and shock—for the patient, for you, and most of all, for their family and friends. You are the one who must make the recommendation for hospice, but the ultimate decision lies with the patient’s family. Let them come to terms with the situation at their own pace, and make a conscious effort to be exceedingly sensitive to their wishes. When the time is right, together you will make a choice that everyone can feel comfortable with.
Finding the Right Hospice
After asking yourself the questions above, you will have a clearer picture of whether hospice is the right fit.
If the patient does indeed belong in hospice, you want to connect the family with a caregiver you can trust. Mission Healthcare provides integrated, holistic hospice care designed to comfort patients and their families when curative measures have been exhausted. To learn more, click here.