Is It Time for Hospice Care?

It Time for Hospice Care?After receiving hospice care at home for the last six weeks of her life, my aunt died of renal cancer at age 44.

Based on that experience and the stories of many others, I assumed hospice was reserved for the last weeks or days of life. But when my grandmother passed away in a nursing home at age 92, she had received hospice care for a little over a year—care that provided great comfort in the later stages of dementia.

After talking with Jon Radulovic, vice president of communications for the National Hospice and Palliative Care Organization, I learned I wasn’t alone in my misconception of the timing of hospice care.

“Thirty-four percent of hospice patients die within seven days or less,” he says. “That’s not enough time to take full advantage of the services.”

The Nature of Hospice Care

Perhaps we don’t take full advantage of hospice services because we don’t understand what hospice is, and what it is not.

First and foremost, says Radulovic, hospice is not “giving up.” It stops curative therapies when your loved one is diagnosed with a terminal illness, but it does not abandon care.

“Hospice focuses on caring for the whole person, striving to help them live as fully as possible,” he says. This holistic care includes services such as symptom control, pain management, assistance with the emotional and spiritual aspects of dying, and bereavement care for family and friends.

Care is provided by a team of doctors, nurses, health aides, social workers, clergy members, therapists, and trained volunteers who develop a care plan to meet each patient’s needs.

“Each person has a unique plan of care,” explains Radulovic. “It’s not one-size-fits-all.”

The Length of Hospice Care

Unfortunately, doctors may be reluctant to talk about hospice because they don’t want patients to think they’ve given up on them, and patients may not realize they can ask about these services.

“Patients think the doctor will bring it up, and doctors think the patient will bring it up,” says Radulovic.

That’s why, if no one has mentioned hospice care to your family, he recommends you start the conversation yourself.

“Ask the physician, ‘Would you be surprised if my loved one died within six months?’ If they say, ‘No, not really,’ it’s time to make the call.”

After all, Medicare hospice benefits require that a patient have a prognosis of six months or less. But, as illustrated in my grandmother’s case, that doesn’t mean hospice benefits are limited to six months. As long as a physician certifies that your loved one continues to meet eligibility requirements, he or she may receive hospice care for as long as necessary.

“Hospice is not just imminent death care,” affirms Radulovic. “It’s designed for the last few months of life.”

When Your Loved One Is Reluctant

No matter how you may feel about it, though, Radulovic points out that the decision to take advantage of hospice care is ultimately up to your loved ones themselves—provided they are of sound mind to make that choice.

He shares that his father, who was suffering from lung cancer, chose to continue aggressive therapies rather than consider hospice. In fact, two days before he died, he was supposed to start another round of chemo. In the end, he received just 36 hours of hospice care before he passed.

“Maybe he would have lived longer with more hospice care, but he was trying to see the birth of his grandchild,” says Radulovic. “It’s still the patient’s decision.”

If you feel it’s time for hospice but your loved ones aren’t on board, consider calling a community hospice provider to get the ball rolling. Professionals can meet with your loved ones and help them make the best decision for their situation.

Ultimately, says Radulovic, now is the best time to start the conversation about end-of-life care.

“It’s really important for patients and families to think about this long before they find themselves in a crisis situation,” he says. “One of the most common things we hear from families after a patient has died is, ‘Why didn’t we get hospice earlier?’”

SHARE YOUR STORY: What are your experiences with hospice care?

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11 comments on “Is It Time for Hospice Care?
  1. Julie Anderson says:

    This article helped my mom and I understand this would be good for my dad. Thank you for posting Monique and Britt for sharing.

  2. Kimberly C. Paul says:

    I would love to talk to you about your experience. Death by Design

    I have a national podcast –

    • Robyn Tellefsen says:

      Thanks for your comment, Kimberly. I was not directly involved in my aunt’s or my grandmother’s hospice experience — my mother was — so I wouldn’t have much personal insight to share for a podcast. Perhaps we can connect for a future related article on this site? I will keep you posted!

  3. Cindy says:

    My dads been on hospice for colon cancer, yet they wanted mom to stop taking him to his heart doctor for his heart condition. We decided hospice was not for us wanting to keep his heart as best possible. I see the good and bad in hospice. Lots of negatives not mentioned here. People be VERY careful about what they will and won’t cover. It’s been a crazy ride with hospice for us finding out a lot the hard way.

    • Robyn Tellefsen says:

      Thanks so much for sharing your thoughts, Cindy. I’m sorry to hear about your dad’s colon cancer, and that it’s been a crazy ride with hospice. I would be really interested in learning more about your family’s experience with hospice — particularly the positives and negatives you mentioned, and what was not covered. In any event, I hope the ride gets smoother for you and your family.

  4. Kacy says:

    Thank you for making us understand hospice care better, the misconception is everywhere so most people end up not making a decision at the right time.

  5. maryjane says:

    great article.

  6. Diane Miller says:

    My parents were just put on the hospice program. They are 95 and 96 years old. They are ready to die but their bodies are not. So I want them to be safe, comfortable and together for as long as possible in their assisted living apartment. I am thrilled they have finally qualified for hospice. They are now receiving services from my agency ( I am an LCSW and work as a bereavement counselor). In the few days they have been on the program, I have spoken with our MD, RN and MSW as well as received calls from admission and on call nurses. They are setting up a volunteer to see my parents (possibly a veteran as my dad is a proud WWII veteran). My parents are an example of how hospice can help people stay at home as long as possible and have medical and emotional support at home. I have not felt like their daughter for the past three years that I have been their caregiver. I have hope hospice is going to help me be the daughter again. And at the very least, I am looking forward to the support that hospice can provide to me as I help my parents make their decisions about their medical care.

    • Robyn Tellefsen says:

      Thank you for sharing your experience, Diane. I’m so glad your parents have finally qualified for hospice, and that you all are already benefiting from the additional support. It would be wonderful if, as you said, hospice can help you feel like your parents’ daughter again, rather than their caregiver. I believe that’s what hospice is designed to do — provide much-needed support and care for patients as well as their loved ones. Best wishes to you and your family!

  7. maryjane says:

    thank you for this.

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