Physicians, patients and families should consider hospice services when medical treatments can no longer cure their disease and/or the symptom burden outweighs the benefits of treatment.
Hospice services can begin when a doctor decides the patient’s life expectancy is six months or less. These services are more efficacious if provided for months rather than days or hours. There is general dissatisfaction among families who believe their loved ones were referred to hospice too late, and having reported more unmet needs, greater concerns, and lower satisfaction with the overall quality of care.
When Should I Refer?
Our team are experienced specialists in end-of-life care, we focus on the comfort of the patient while making each day count, instead of counting down the days. It is important as a physician to speak with patients and their family about the benefits of hospice as soon as they may qualify. By doing so, this will allow the patient to spend their time being as comfortable as possible, being cared for by our 5-star rated hospice team, and preparing the family for the future.
Typically, a patient is referred to hospice when their life expectancy is 6 months or less depending on the course of their disease. This prognosis is the physician’s best estimate of how long the illness will take to run its course before the patient dies. Another requirement is that patients who elect hospice must forgo curative treatment, either because they no longer wish to receive it or because it is no longer effective. When the burden of treatment outweighs the benefits and/or the patient has had multiple hospitalizations over the last several months, he or she might be ready for hospice. Other indications include:
- Excessive sleeping throughout the day
- Weakness during daily living activities
- Unplanned weight loss
- Multiple hospital visits/stays in the past six months
- Excessive swelling of the legs and ankles
- Difficulty breathing at rest or with increased oxygen levels
- Pain that is not minimally controlled
- Loss of interest in activities that were once enjoyed
- Trouble sleeping due to pain, shortness of breath or other symptoms
- Not “bouncing back” after an illness
- Not responding to current treatments or therapy
- Loss of appetite and/or speech
- Frequent changes in medications
- Confusion
- Wounds that aren’t healing and Infections
If as a physician, you find it difficult to speak with patients and their families about hospice, feel free to call us any time for suggestions on how to talk about hospice, or if the family is interested we can speak with them directly to help understand the benefits and importance of hospice care.