Am I Ready for Hospice Care?

Dana Nolan, MS LMHCLicensed Mental Health Counselor

What Is Hospice Care?

Patients with a limited prognosis Usually home-based care Caring vs. curing Individual plan of care Multidisciplinary Family or caregiver support

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Criteria for Hospice Care

Patients may enter hospice care when their life expectancy is6 months or less or if their illness runs its normal course.

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Patients with multiple serious illnesses may meet criteria with physician recommendation that the combination of illnesses will shorten life expectancy.

Note: Use these as guides.

Statistics

The first hospice organization was started in 1974.

Today, there are close to 6,000 hospice programs in the U.S.

The average length of hospice service is about 72 days, but there is great variation in length of service depending on timing of the referral and patients acceptance of referral.

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Who Pays for Hospice Care?

Hospice is covered under Medicare, Medicaid (47 out of 50 states cover it) and most private insurers.

Patients receive hospice care

regardless of ability to pay (sliding scale or uncompensated/charity care).

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Who Should Talk About Hospice First?

Patients and families may bring up hospice care at any time. Patients and caregivers may be reluctant to ask questions because they fear their oncologist will think they have given up. Physicians vary in how and when they may discuss the potential of a hospice referral, but are usually open to discussing it when their patients ask questions about it.

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Who Provides Hospice Care?

Multidisciplinary team: Physician, nurse, counselor/social worker, chaplain, volunteers, home health aids, ancillary (dietitian, OT/PT).

Hospices usually employee physicians who specialize in palliative care, but you can use your PCP or oncologist if they are agreeable to continue managing your care.

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Where Is Hospice Care Provided?

Patient’s place of residence which could be their home or a nursing home (66%).

Inpatient hospice facility

Acute hospital setting

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Are All Hospices the Same?

Certified hospices must all provide the same basic level of care, but many offer more services or have their own inpatient facility so it is worth interviewing several hospices.

There may be more than one hospice agency that provides care in your area.

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Benefits of Hospice Care

Home-based: bring care and equipment (shower chair, hospital bed, supplies) to YOU.

Individual care available (on call 24/7).

Their specialty is end-of-life care (pain and symptom management experts).

Staff support and educate the caregivers on how to best care for the patient.

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Can I Discontinue Hospice Care?

Yes! If a new treatment becomes available (or a clinical trial opens up), you can discontinue hospice care and resume curative treatment.

If you feel better or your disease

stabilizes, you can discontinue hospice and resume if needed in the future.

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How Will I Know It Is Time for Me to Consider Hospice Care?

Subjective quality of life Risk or benefit of further

curative treatment.

Prognosis

“What is important to me?”

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Family Issues Some patients decide they are ready for hospice

but don’t pursue it because family is not supportive and wants patient to continue treatment.

“I can’t give up!” “I am not a quitter.” “Everyone has told me to not give up hope and to keep fighting.”

The best support a mesothelioma patient can get from their loved ones is hearing: “I’ll support whatever treatment decision you choose.”

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Resources for Hospice Care Questions

Health care chaplainsOncology social workers or

mental health professionals Oncologist or oncology nurses Hospice agencies

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Sources

National Hospice and Palliative Care Organization (2014) NHPCO’s Facts and Figures: Hospice Care in

America.

Hospice Net (2016) Questions about Hospice. Retrieved from http://www.hospicenet.org/html/faq-pr.html

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Contact Information

1-800-615-2270

(800) 615-2270