A sad reality surrounding hospice is that many families express that they wish they were informed about hospice services sooner. Often patients are not offered hospice until no other options exist for curative treatment or the patient is too debilitated to participate in further treatment. While services can be started at any time once a doctor has certified terminal illness with a prognosis of six months or less, just when should you talk to someone about hospice?
Patients and their families look to their healthcare providers as a source of information, symptom relief, and guidance. This is why it is so important to build a rapport with the people we serve. It is imperative to remember that patients look to their healthcare provider for answers, and some are willing to continue in a treatment that they may not necessarily wish to have in order to avoid appearing as if they have lost confidence in their doctor. Still others will enter chemotherapy programs to satisfy the wishes of a loved one.
Prognosis Of Six Months Or Less
As healthcare professionals, the primary focus must be on what is in the patient’s best interest at all times. Knowing the right time to talk to someone about hospice is invaluable and can make the experience easier on families. As mentioned previously, once a patient has been given a terminal diagnosis and a prognosis of six months or less, hospice services should be discussed as an option. A patient may or may not be willing to consider comfort care initially; however, it can lay the foundation for any future discussions regarding hospice should the patient choose to enter comfort care.
Key Indicators That It Is Time To Discuss Hospice
While there are some patients who seek hospice immediately after receiving, there are others who may view hospice as being given up one. For those patients, we must delicately approach the discussion and offer support while they are processing the information. Let’s shift our focus for a moment to some specific symptoms that could prompt the hospice talk. The following is a list of some of the signs that may indicate that it is prudent to offer hospice services. This is not an exhaustive list, but rather, a short list to help you to know when to act.
Difficulty Managing Symptoms
Whether it is frequent medication adjustments, or failure to respond to therapy, when a patient stops responding to treatment, it is certainly time to offer hospice services. The goal of hospice is to provide quality medical care that brings comfort to a patient and their families. This means having access to some of the finest hospice medical providers who truly treat each patient with an individualized care plan aimed at maximum comfort. Uncontrolled pain, respiratory difficulties, and other issues such as worsening cognition may be indicators of declining health. Hospice offers a comprehensive team of medical professionals who will develop a care plan based on each patient’s individual needs.
Increasing Number Of Office Visits
Often, an uptrend in the frequency of the number of trips to the doctor’s office is an indication that disease progression is occurring and it may be a good time to discuss hospice as an option. Comfort care is not a lack of medical care, but rather, it is care that is centered around allowing the patient to spend the most quality time available to them in their home comfortably surrounded by family. Instead of constantly having to get appointments to see their healthcare provider, hospice services are provided to the patient in their own home. They have 24 hour access to their hospice attending physician, they can speak with their nurse who is one call if they need to, and even receive an after hours visit if warranted.
Frequent Hospitalizations And Subsequent Readmissions
The goal is always to try to manage a patient through ambulatory care first, and to avoid hospitalization if possible. Once you see that a patient is suddenly requiring frequent trips to the emergency room and having hospital admissions, it might be time to discuss how hospice services can help avoid the constant need for hospitalization to manage disease progression. Also, frequent infections requiring iv management, or intractable pain or respiratory symptoms that necessitate high level interventions are also key indications.
As health declines, it may become more difficult to maintain patient care without hospitalization. In addition, once a patient is discharged, if they are subsequently requiring frequent readmissions for the same condition, hospice should be discussed. Patients who are not able to transition directly home after a hospital stay, and require rehabilitation therapies are also ones who would benefit from having the kind of care that hospice can provide.
Non-Compliance Can Be An Indicator
As frustrating as it may be when a patient is noncompliant with their medication regimen or treatment plan, this can be a sign that they are no longer desiring treatment. By recognizing that a patient may be done with the curative treatment path, and offering them an alternative such as comfort care, we are doing the right thing at the right time. Waiting until all treatment options are exhausted is not the choice that everyone wants to make. Recognizing that some individuals value quality of life over quantity of time is an important part of caring for our patients.
Benefits Of A Timely Hospice Referral
Often, patients who transition to comfort care tend to see initial improvement in their condition and it can be a huge stress reliever to the patient and their loved one as they navigate the end of life process. Those who desire to be in the comfort of their own homes, enjoying the activities they are able to do, and having loved ones close by are afforded that opportunity when they elect the hospice benefit. Services are generally covered by the Medicare Benefits, DME is also provided, as well as a dynamic medical team who are ready to create a specific care plan that meets the needs and goals of each individual patient. In addition to the care provided to the patient, their family and caregivers are also provided the much needed support that will enable them to get through to the end.
Don’t worry if you are unsure of all of the details and specifics on what the hospice benefit includes. We are here to help support you. Contact us with any questions and we will assist you in this process. We would love to show you how Siena Hospice in Las Vegas can provide the quality comfort and exceptional medical care that your patient needs.