When is it time for Hospice?

“I wish I had chosen hospice care sooner” is a common sentiment expressed by hospice patients, their families, caregivers and even physicians and nurse practitioners who refer patients to IE and OC. If you are asking yourself if it’s the right time to choose hospice care, the answer is likely yes.

A study found that those who receive specialized hospice care early in the process of a life-limiting illness often improve temporarily, able to experience the benefits of pain relief, symptom management and comfort care to ease anxiety, depression and fatigue.

Life limiting disease or conditions?

The most common disease and conditions associated with hospice care, according to the National Hospice Organization, are:

  • Cancer (28%)

  • Cardiac and circulatory diseases (19%)

  • Dementia/Alzheimer’s (17%)

  • Respiratory disease (11%)

  • Stroke (9%)

Loved one showing these signs of decline?

The following factors are good indicators that it’s time for hospice:

  • A doctor has certified the patient has six months or less to live if the condition/disease follows its normal course
  • Curative treatments (medications, chemotherapy, rehab, etc.) are no longer effective or create side effects that prolong suffering, discomfort and pain
  • The patient has decided to stop testing, hospitalizations and treatments in favor of palliative care

  • The patient is increasingly unable to perform the activities of daily living (personal hygiene, dressing, eating, maintaining continence, transferring)

  • If yourself or a loved one is experiencing  any of the following over 4-6 months:

  • Loss of 10% or more of body weight
  • More than 3 hospitalizations or emergency room visits
  • Presence of other co-morbid conditions
  • Declining physical activity
  • Declining mental alertness/cognition

Take the loved ones wishes into consideration

A patient’s preferences for end-of-life treatment will be spelled out and easy to follow if they have an advanced care plan (ACP).

This includes a living will, durable power of attorney for healthcare, or (in some states) a Five Wishes document. If the patient has made it clear that certain procedures or interventions should or should not be pursued in the face of a life-limiting illness, the hospice team can craft a care plan that honors the patient’s wishes while focusing on the quality, not the quantity, of time that remains.

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