Wondering when to begin hospice services? Here are three questions that can help you decide if it is time to start hospice:
1. Are you facing one of these life-limiting diseases or conditions?
- Cancer
- Cardiac and circulatory diseases (CHF)
- Dementia/Alzheimer’s
- Respiratory diseases (COPD)
- Stroke
- Kidney/Liver diseases
- ALS
- Lou Gehrig’s disease
- Immune disease
2. Is the client or loved one showing these signs of decline?
The following factors are good indicators that it’s time for hospice:
- A doctor has certified the client has six months or less to live if the condition/disease follows its normal course
- Curative treatments (medications, chemotherapy, rehab, etc.) are no longer effective or create side effects that prolong suffering, discomfort and pain
- The patient has decided to stop testing, hospitalizations and treatments in favor of palliative care
- The client is increasingly unable to perform the activities of daily living (personal hygiene, dressing, eating, maintaining continence, transferring)
- Over 4–6 months, the client has experienced any of these:
- Loss of 10% or more of body weight
- More than 3 hospitalizations or emergency room visits
- Presence of other co-morbid conditions
- Declining physical activity
- Declining mental alertness/cognition
3. Have you taken the client’s wishes into consideration?
A client’s preferences for end-of-life treatment will be spelled out and easy to follow if they have an advanced care plan (ACP). This includes a living will, durable power of attorney for healthcare, or (in some states) a Five Wishes document. If the client has made it clear that certain procedures or interventions should or should not be pursued in the face of a life-limiting illness, the hospice team can craft a care plan that honors the client’s wishes while focusing on the quality, not the quantity, of time that remains.
If you have questions about hospice appropriateness, contact the admissions department of a local hospice. The staff should be able to answer questions or send a clinician to evaluate the client and meet with the family at no cost. Aided by this information, you’ll have a better sense of when the time is right for hospice care.
