When should we contact Hospice?
Question: Recently my dad’s doctor informed us that dad (he’s 83) probably has about six months left to live. He has suffered for years with various heart ailments and there’s just nothing else that can be done. Dad says he wants to go to the Hospice Home, but I feel it’s too early for that. When does a person usually go to Hospice?
Answer: I know this is a difficult prognosis for you and your family. Enjoy and love each other during the time you have left. Though six months seems so short, you have been given the precious gift of a season to say good-bye. Use it wisely.
Why does your dad want to go to the Hospice Home? Did his doctor suggest that he do so? What are his current living arrangements? Does he understand that Hospice provides comfort (as opposed to curative) care? Does he feel that he would be a burden to his family if he stays home? If your dad is willing and able, discuss with him why he is making this request. Ultimately, this decision should be his.
Generally, a person with a life expectancy of less than six months – as determined by a physician – is eligible for hospice services. The patient’s doctor makes the referral. In 2016 the average length of a hospice stay was approximately 71 days and the median duration was 24 days. Almost 35% of patients died within seven days, which shows that many times patients (or their families) wait until death is imminent before taking this step. No doctor can determine an accurate prognosis of exact time of death, and studies have shown that doctors often overestimate life expectancy. Sometimes families resist contacting hospice because they feel that would be “giving up” on their loved one. This is unfortunate, because the purpose of hospice is to enhance the quality of life for patients and their families.
Hospice support is also available at long-term care facilities and in a patient’s home. Your dad may not be aware of the home option, and may prefer it at this time. The same services – palliative care, pain (the most prevalent end-of-life physical symptom) management, bereavement counseling for the patient and family, and respite care for caregivers are all available at home. The Medicare Hospice Benefit covers expenses at home, in a facility or at a Hospice Home, and includes medications and personal medical supplies, once the criterion of a six-month or less life expectancy has been provided.
As a nurse, I have always been impressed by hospice personnel and the services they provide. Several loved ones in my family have received hospice care. One word of caution:
Chaplains at hospice facilities come from an array of religious and non-religious backgrounds. If it is important for your family and your loved one to receive services from a chaplain that shares your beliefs, I advise you to make this request known before or upon admission.
Statistics from Statista.