The decision to place a loved one in the hands of a dedicated hospice care team is never an easy one, and many family members often struggle with the decision. In fact, deciding on hospice care can be a source of contention if various family members believe that a loved-one is not yet ready for hospice care.
Accepting that a loved-one has a life-limiting illness is always a challenge, even when the patient is requesting hospice care. It can be hard for family members to get on the same page, which might lead to putting-off the hospice decision for some time.
While this delay might derive from good intentions (including family members who are still hopeful for additional treatments) it can increase the stress of the situation for everyone involved. The loved-one may no longer feel like undergoing treatments or being in a hospital setting but may try to continue at the request of family members. This could be detrimental to the loved-one’s health and could lead to tension with multiple members of the family.
When It Makes Sense to Consult with a Hospice Care Team
Consulting with a hospice care team can have numerous benefits however—not just for the patient, but for the family members as well. The process of accepting that a loved one has a life limiting illness is extremely difficult for anyone, and the decision to move forward with hospice care can be an official recognition that the patient does indeed have a life limiting illness that may no longer be benefiting from traditional treatment methods.
Unfortunately, however, this discomfort in considering the benefits of hospice or misconceptions about hospice care itself could lead family members to avoid getting a loved one the necessary hospice care until it is too late. Although any patient can benefit from hospice care at any stage of a life-limiting diagnosis, the sooner family members and the loved-one recognize the advantages of hospice services, the more comfort and care will be provided from this very service.
Most people would prefer to pass away peacefully in the comfortable setting of their own home. However, recent studies have indicated that almost one in three individuals at the end of their life will spend some time in a hospital’s intensive care unit in the last month of their life. This same study also indicated that a similar number of individuals only receive hospice care just a couple of days before passing away. This can put unnecessary stress and pressure on the patient as well as his or her family members.
The Cost of Late Hospice Referrals
Late hospice care referrals may come at any stage in a patient’s illness. However, researchers in recent studies have found that approximately 40% of those referrals come immediately after an ICU stay in the hospital.
Hospice care should always be considered as a treatment for those individuals who want to remain focused on their quality of life. Failing to get assistance sooner rather than later could give the patient a less than positive experience and allow them to have a challenging time inside the hospital, outside the comfort of their own home. Unlike a traditional hospital stay, hospice care can frequently be provided in the patient’s own surroundings, giving him or her more of a sense of peace and comfort during a very difficult time.
Why Hospice Care Frequently Occurs Too Late
There are many complex reasons why hospice care is frequently only administered during the last couple of days of a patient’s life. Sometimes this can be due to a sudden change in a patient’s healthcare status that does not leave individuals around him or her the appropriate time to prepare. Another reason, however, is that people frequently don’t realize the benefits of hospice care or are simply referred to it too late.
Patients may not fully comprehend their prognosis and may not have had a conversation with their primary physician about what is important to them. One other challenge is in the way that healthcare services are reimbursed. ICU doctors and ICU care specialists are reimbursed for their services. However, Medicare does not pay specialists or primary care doctors to always sit down with their patients and have critical discussions about end of life care, or what stage in a life limiting illness when hospice care should be considered. One of the best ways for a loved one’s wishes to be honored in some situations is to obtain hospice care.
When to Choose Hospice Care
Hospice care is a vital support system that can help the patient with the bulk of his or her needs toward the end of their life, giving family members a break in caregiving. Hospice or palliative care can give a more comfortable and more dignified alternative for a patient who has received a diagnosis of a life limiting illness.
Recognizing that treatments inside the hospital or elsewhere can be more problematic and can lead to negative side effects without potentially curing the illness could lead a patient to request that he or she be able to receive hospice care. It can be more difficult for family members to come to this conclusion as they may not want to accept that a loved one has these wishes or has come to a place of acceptance with their own illness as well. Hospice care assists patients with managing their pain while also providing special care to enhance the quality of life for family members and the patient. This is not about giving up hope but rather allowing patients to receive the most appropriate and necessary care in their last phase of life.
How Hospice Works
Hospice is traditionally recommended to those individuals who have a life expectancy of six months or less, and, rather than ongoing measures designed to help, cure, or treat the illness, it is focused on symptom and pain relief. This allows a patient who has been affected to live their last days with dignity, purpose, support, and grace. The majority of hospice care is provided in a patient’s own home, although it can also be provided in nursing homes, hospitals, or other healthcare facilities. With no age restriction on hospice, anyone who has received a life limiting diagnosis may be eligible to receive hospice care.
The hospice care team will work together to generate a comprehensive approach to a patient’s emotional, physical, spiritual, and social needs. The team may include individuals like a counselor, a case manager, the patient’s primary physician, a minister, social workers, and others. The care plan will be developed in line with the patient’s individual needs. This can ease a great deal of pain and frustration for loved ones who may have been trying to handle a patient’s needs on their own or in conjunction with the care provided at a busy hospital.
In addition, certified home health aides may also be brought into the situation to assist with personal care services. Loved ones who are coping with a family member who has been diagnosed with a life limiting illness may find that they are able to have better support and understanding during this challenging time, minimizing a great deal of their fears and frustrations.
It is never easy to accept that a loved one has been significantly affected by a life limiting illness but attempting to have that loved one stay inside the hospital and receive treatments that are no longer effective or desired by the patient only adds additional stress. Hospice care, on the other hand, can allow him or her to receive the symptom-relief and pain-relief they need, while also remaining in their own surroundings with family members, who are often part of their overall hospice care team. Having a conversation as a family about the benefits of hospice can help to defray some of the misconceptions about this situation.
Having a conversation with the patient is strongly recommended for determining whether or not hospice is the right choice. Although family members might not be ready yet to accept this choice, hearing the request directly from a loved-one can help persuade family members, further minimizing the loved one’s suffering and risk of displacement.
Hospice care is a wonderful way to support a loved one who has a life limiting illness and wishes to be in his or her own surroundings, such as their home, while also getting pain and other symptom relief. The right hospice care program can go a long way toward giving peace of mind to everyone involved in this situation. Hospice care providers allow for support and specialized knowledge at the end of a patient’s life. Many patients also feel as though they are less of a burden to their loved-ones after opting for hospice care that provides holistic support.