Educated decision making is essential for professionals acting in the capacity as their clients’ primary advocates for health and wellbeing. Many important decisions revolve around healthcare needs. While the decision to hire a home care provider is typically an easier one, answering the question – is it time for hospice – is often more difficult. Here are some indicators that hospice might be the most appropriate level of care for your client:
It Might Be Time for Hospice
Let’s begin by addressing the more difficult question. How do you know when hospice care is necessary and that it’s the right time for hospice? Only a doctor can refer a patient to hospice care. However, there are some signs you can look for and discuss with your client’s medical care team. They include:
- Multiple hospital admissions within a short period of time
- Advanced age combined with declined health status (ie: unable to talk, walk, eat or get dressed independently)
- Disease treatments no longer seem to be working or are uncomfortable to the point that your client wishes for them to stop
- Disease symptoms and side effects seemingly cannot be controlled and cause discomfort
- Significant problems with a number of diseases and conditions that negatively impact quality of life
- Unexplained and difficult to manage weight loss
- Spending most of the day in a chair or in bed and increased sleep needs
- Extreme exhaustion when ambulating
- Shortness of breath even while sitting or lying down
- Multiple falls within a short (few months) period of time
- Rapid and unexplained decrease in appetite
- Sudden changes in mental status
Keep in mind that most of these indicators alone will not qualify a patient for hospice care. However, combined they can indicate that quality of life has diminished and care needs are increasing. For a client with these symptoms and a terminal illness, and especially when that individual no longer wishes to receive or benefits from curative treatments, this highest level of care offers the most support and supervision. Thus, it provides your client with the greatest opportunity to receive optimal symptom management. They will benefit from pain relief, emotional and spiritual care. This improves quality of life for whatever time they have left.
Who is Hospice Care Appropriate For
Next, we’ll review a summary of hospice care basics. Hospice care is appropriate for individuals with a serious medical condition and those who have a life expectancy of six months or less if the disease follows its expected course. A doctor’s referral is necessary for hospice care. Medicare, MediCal, VA benefits and private insurance typically cover this service at 100-percent. Once a referral is made, the hospice care nurse evaluates the patient, and a plan of care is created with the goal of managing your client’s symptoms and improving quality of life. As this is the highest level of support available, expect that your client’s physical, emotional and spiritual needs will be met by a team of professionals with expert knowledge in end of life care.
Common Myth About Hospice
Finally, let’s dispel a common hospice myth. Entering hospice care does not have to mean that your client is days or weeks away from death. In fact, research shows that patients who enter hospice care sooner benefit more with regards to comfort and quality of life. Waiting too long to seek a hospice care referral could result in more aggressive measures. This can negatively impact quality of life while in no way increasing your client’s opportunity for a cure.
To further dispel this myth, consider the words of an expert in hospice care, Dr. Christopher Nguyen, MD, MBA and Geriatrician with the Centers for Family Medicine. He states, “Early hospice referrals BENEFIT, never harm, the patient, family and support system. A timely referral leads to improved quality of life and improved symptom control, as well as spiritual, social and emotional support for the patient and their family members.”
Is Hospice the Right Choice
If you’ve considered all of the above and are still uncertain about whether or not it’s the right time for hospice, there are a few more questions to ask yourself. What would the impact on quality of life be if you did not refer? Would it be negative or positive? Is there a potential your client would end up with medical complications that could have been avoided by seeking a higher level of care? If the answer is yes or you’re still unsure, consult with their doctor to find clarity in this difficult decision making process.
Hospice care offers the highest level of support and often benefits a client who is suffering from a terminal illness. While the decision to enter hospice care is never an easy one, consider how this service might provide your client. Providing them with the support they need improves their quality of life.
Salus is here to assist as you make important decisions regarding your client’s care needs. Our continuum of care ensures that they receive the right level of support throughout their health care journey. You also receive assistance to ensure they enjoy a higher quality of life. Contact us anytime to discuss your client’s needs or schedule a no cost, no obligation consultation.
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