When can you start hospice care?
I know that hospice can be a big topic, especially for those working with the terminally ill, so I tried to keep things simple and informative by sharing some information for the Hospice Foundation of America (USA).
I first shared this over on Instagram and got a few really nice comments from fellow death workers. Basically, literacy on this subject is important for the general public! Seriously! In the US, most people who experience non-accidental death will experience hospice as the “end of the road” as they approach their death. Every single person I have known that’s died from prolonged illness has worked with hospice in some way. It’s important to know what all of it actually is and what it means for you so you can mindfully decide if you actually want to engage hospice.
Hell, you might opt instead to leave medical care to die at home, with cannabis for your pain and anxiety and a psilocybin trip to help you find deeper meaning as you take your last breaths. Things in the death world are changing, y’all!
Regardless of your opinions on hospice — whether it’s overinflated misuse of Medicare or a wonderfully supportive and collaborative gift of a service, it’s important to educate yourself and those around you. Please take the time to learn about this before the decisions are thrust upon you in crisis.
When is it time for hospice?
Deciding when it’s time for hospice is difficult and should be discussed with loved ones and a physician. It is generally time for hospice when:
the patient has 6 months or less to live, according to a physician.
the patient is rapidly declining despite medical treatment (weight loss, mental status decline, inability to perform activities of daily living).
the patient is ready to live more comfortably and forego treatments aimed at prolonging life.
Hospice is:
medical care to help someone with a terminal illness live as well as possible for as long as possible, increasing quality of life.
an interdisciplinary team of professionals who address physical, psychosocial, and spiritual distress focused on both the dying person and their entire family.
care that addresses symptom management, coordination of care, communication and decision making, clarification of goals of care, and quality of life.
List of Services:
The vast majority os hospices follow Medicare requirements to provide the following, as necessary, to manage the illness for which someone receives hospice care:
time and services of the care team, including visits to the patient’s location by the hospice physician, nurse, medical social workers, home-health aide, and chaplain/spiritual adviser.
medication for symptom control or pain relief.
medical equipment like wheelchairs or walkers and medical supplies like bandages and catheters.
physical and occupational therapy.
speech-language pathology services.
dietary counseling
any other medicare-covered services needed to manage pain and other symptoms related to the terminal illness, as recommended by the hospice team.
short-term inpatient care (e.g. when adequate pain and symptom management cannot be achieved in the home setting)
short-term respite care (e.g. temporary relief from caregiving to avoid or address “caregiver burnout”)
grief and loss counseling for patient and loved ones.
Facing tough decisions near the end of life
When determining if hospice is the right decision, these questions will guide the conversation. Do you/your loved one want:
artificial nutrition and hydration (whether or not to have a feeding tube or intravenous fluids)?
cardiopulmonary resuscitation (CPR) (whether or not to restart the heart if it stops beating)?
mechanical ventilation (intubation) (whether or not to use a breathing machine to breathe for a person whose lungs have stopped working)?
to discontinue treatment aimed at curing the disease in order to pursue comfort care?
