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Resources
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Physicians' Notes |
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When is the best time to enroll in a hospice program?
Jason M. Sobel, MD
Hospice care has three primary goals: managing symptoms; addressing a variety of other needs (e.g., emotional and spiritual needs); and preventing hospitalization due to crisis. To accomplish these goals, an interdisciplinary team works together to provide a range of services … wherever the patient calls home.
You are eligible for hospice services if two physicians—typically your primary care physician and the hospice physician—agree that there is a “reasonable expectation” your health will decline further and that you have six months
or less to live if your illness follows its natural course.
When making this prognosis, physicians take several factors into account—
for example, the type of illness you have, how severe your symptom are,
how well you can function—as well as the rate of change in these areas
over the previous weeks or months.
Because physicians are human like everyone else, they possess natural
tendencies that may unintentionally limit a patient’s access to hospice care.
One tendency is to be overly optimistic—physicians hold on to the hope
that things just may get better. Another tendency is to wait for the patient
to express preferences about discontinuing hospital-based treatments, such
as chemotherapy or IV antibiotics.
So you may need to take more control over your healthcare by starting a
conversation with your physician about your prognosis and healthcare goals.
This conversation may lead to discussing alternate treatments you can consider.
Or it could be your opportunity to express your desire to change course …
to focus on being as comfortable as possible during the time you have.
Enrolling in a hospice program is not about giving up. Rather, it is about
choosing to focus on symptom control, comfort and support—pausing at
the end of a very difficult battle, reflecting on your journey and taking a new
direction with your healthcare. While this direction may be unsettling at
times, it can offer the possibility of better pain and symptom management
as well as a sense of closure for you and your loved ones.
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