Hospice care is a type of medical care designed to provide palliative care for terminally ill patients during the last six months of life. This type of care is reserved for patients who are no longer receiving curative treatment. Palliative medical care is an important part of hospice care. This means making sure the patient is as comfortable as possible and relieving their pain and discomfort. Hospice care also includes help with day-to-day activities, assistance for caregivers, and emotional support.
Accepting hospice treatment can be an emotional decision. After years or months of battling an illness with aggressive treatments, it can be hard to relinquish control. It can feel like you’re “giving up” or letting the disease win. But hospice care can be a blessing when a loved one reaches the end of a long, painful illness. It can make their final months or days less stressful and much more peaceful. As Malene Davis, president of one of Washington’s largest hospice services puts it, “If we can manage and alleviate pain, we can help reinvigorate patients to help them accomplish whatever it is they want to do in their remaining days.”
However, knowing when to start hospice care can be difficult. While the number of patients enrolled in hospice programs has increased dramatically in the past twenty years, only 43 percent of patients who are eligible for hospice accept the services once referred. While every patient’s situation is different, here are five signs that hospice may be the right move.
A Doctor’s Referral
Most physicians are trained to treat and cure diseases, and don’t specialize in palliative care. If a doctor judges that hospice is the best option for a patient, it means they realize that it’s time for the patient’s quality of life to come first. Before admitting patients, most hospice programs require a doctor’s order and the approval of the hospice medical director. Both need to verify that the patient has six months or less to live. If a patient outlives that time, they can be “recertified” to continue hospice care. If the disease goes into remission, hospice care can be suspended and treatment can continue.
Repeated Visits to the ER
Even before a doctor suggests hospice, there are some signs caretakers can look for. It may start to seem like you’re always in the emergency room or if you’re constantly in and out of the hospital. In this case, it may be time to ask the doctor about hospice care.
As the body weakens, its ability to fight infections decreases. Recurrent respiratory infections or skin infections associated with skin deterioration common near the end of life are a sign to watch for.
Significant, Progressive Weight Loss
Major weight loss could be a sign that a patient isn’t eating or drinking. First ask your doctor if medication or other medical treatment makes them too nauseous to eat. However, it could be a sign that their body isn’t responding to medical treatment and may signify end of life.
Sleeping Much More than Usual
Changes in sleep patterns are common with a terminal illness. Sometimes this is caused by medications or simply exhaustion as they try to fight the disease. However, an increase in sleep, withdrawal from family, no desire to communicate, and a sharp decrease in energy can signify that it is time for hospice care.
Educate yourself early – before you are forced to rush a decision – about the care that hospice provides. Talk to family members about hospice care and find out their opinions. Communicate with your doctors, nurses, and other medical caregivers openly and honestly about end-of-life care. It can be an uncertain, frightening situation; but knowledge and communication can help ease the pain.