When the doctor recommends hospice, the response is typically either, “Thank goodness," or it's, “Oh my God! No Way!”
This message is for the second group. Read on, dear ones . . .
When your doctor recommends hospice, it’s NOT because your doctor has "given up" or doesn’t care. It’s because your doctor (or your loved one’s doctor, as the case may be) recognizes that:
Given the trajectory of the disease you/your loved one is facing, one may expect that someone of a similar age, with a similar diagnosis and/or comorbidities may expect to live another six months if the disease follows its typical or known path
Know that the six-month prognosis is an important aspect of a hospice referral, and that this is based on evidence-based information about that particular disease, also known as the “hospice diagnosis.” The actual length of time in hospice care may vary from days to months to years, and this often depends on how far along the disease has progressed at the time that it’s diagnosed. For someone receiving regular, preventative healthcare, diseases are typically identified and treated early on, giving medical professionals the time to properly treat the condition or symptoms, and to anticipate the best course of action/treatment in an ongoing manner. When a disease is identified too late in the game—when it’s silently progressed to a stage where treatment is either futile or contraindicated—we can expect a shorter time in hospice care.
Your/your loved one’s doctor has done all that they can do, medically and ethically to treat the disease
This often involves medications, supplemental oxygen, surgery, chemotherapy, or other interventions. Understand that your doctor has chosen their profession because it allows them to provide the utmost care, treatment, and comfort to their patients. Most often, your physician will look to you and will choose to honor your goals when deciding on a course of treatment. If your physician believes that your survival rate will increase with additional treatment, even if only for a short time, they’ll likely recommend that. If more treatment is either futile, or likely to do harm, a conversation about hospice will likely ensue. This is your doctor’s acknowledgement that it’s time for other medical professionals—a hospice care team—to take over your care.
You/your loved one need a level of specialized support and medical care that only hospice can provide:
Your hospice care team includes an attending physician (your hospice MD) whose specialty is palliative care/symptom management, who knows a great deal about disease processes, and who also knows about the emotional needs of someone who is nearing end of life.
You will have a Registered Nurse (RN) who reports directly to the MD, and who will manage the day-to-day symptoms and medication needs.
Your CNA (Certified Nurse’s Assistant) reports directly to the RN to collaborate daily needs, including care such as bathing and dressing.
Your Social Worker (MSW, LSW, or LCSW) will provide emotional and practical support, counseling, education, and will often lead meetings/care conferences with you and your family to address needs and goals.
Your Chaplain (MDiv) will attend to your spiritual needs and help with funeral and/or memorial planning.
This incredible team of people—while seeing you separately—work in tandem to provide the highest level of care and support you expect and deserve. They are your team and you will come to know them well, depend on them, and know that they care about you.
Finally, your doctor recognizes that quality of life is important, and being in hospice, when one has a terminal illness or impending death, provides the highest quality of life that’s available through the medical community.
Hospice comes to you, wherever you are—whether it be in your home, in a care facility (nursing home, assisted living, etc), or in a homeless shelter. Regardless of income or place of residence, you will receive the highest level of care from everyone on your care team.
Comfort care is always a goal with hospice. Everyone deserves a “good death.”
Hospice cares for the entire family (patient, loved ones, and caregivers), and provides grief support to surviving family members/loved ones for up to 13 months after the death of the hospice patient.
I'd like to extend a special thank you to Julie Maxon, Director of Community Partnerships at Dignity Hospice, for this additional information:
"We offer complete coverage of medications directly related to a patient’s hospice diagnosis as well as medications for comfort. We also provide any necessary Durable Medical Equipment and when needed, necessary medical supplies such as briefs, wipes, gloves, wound care supplies etc. We provide Massage Therapy (we absorb the costs, something special Dignity provides that sets us apart from other hospices), Pet Therapy, and we acknowledge Veterans with pinning ceremonies.
"Hospice is covered by Medicare/Medicaid benefits for as long as a patient is eligible. In some circumstances, coverage may fall under private insurance policies."
I sincerely hope this dispels any myths or misconceptions you have about hospice. This is a BIG subject, both regarding details of the hospice benefit, and also in terms of the emotions that accompany a hospice referral.
Sending love and light . . .