What makes someone eligible for hospice? Part 2

Facing a terminal illness is an emotionally challenging experience, and decisions about end-of-life care require careful consideration. Hospice care is often recommended when individuals are dealing with life-limiting illnesses, aiming to enhance the quality of life during their final months. In this blog post, we will explore when hospice is recommended and the reasons behind this crucial decision.

I. When is Hospice Recommended?

Hospice care is typically recommended when an individual has been diagnosed with a terminal illness and their life expectancy is six months or less, as determined by the treating physician and the hospice medical director. Some common scenarios in which hospice may be recommended include:

  1. Advanced Stage of Illness:
    • When a medical condition has progressed to an advanced stage, and curative treatment options are no longer viable or beneficial, hospice becomes a valuable option. This may include diseases such as cancer, advanced heart failure, or late-stage neurological disorders.
  2. Decline Despite Treatment:
    • If the patient’s health continues to decline despite undergoing aggressive medical treatments, the focus may shift from curative care to providing comfort, pain management, and emotional support.
  3. Frequent Hospitalizations:
    • Individuals experiencing frequent hospitalizations due to complications related to their terminal illness may find relief and enhanced comfort in hospice care. Hospice aims to minimize hospital visits and provide care in a familiar and supportive environment.
  4. Choosing Quality of Life:
    • When the emphasis shifts from prolonging life to improving its quality, hospice becomes a recommended option. Hospice care focuses on managing symptoms, alleviating pain, and enhancing the patient’s overall well-being.
  5. Exhaustion of Treatment Options:
    • When available treatment options have been exhausted, and further interventions are unlikely to provide significant benefits, hospice care offers a compassionate and holistic approach to end-of-life care.

II. Reasons Why Hospice is Recommended:

  1. Pain and Symptom Management:
    • Hospice care prioritizes effective pain management and symptom control, aiming to provide comfort and alleviate distressing symptoms associated with the terminal illness.
  2. Emotional and Spiritual Support:
    • Hospice care teams include professionals such as social workers and spiritual counselors who offer emotional and spiritual support to both the patient and their family, helping them navigate the emotional challenges of the end-of-life journey.
  3. Choice of Location:
    • Hospice care allows individuals to receive care in the comfort of their own home or in a hospice facility, providing a familiar and supportive environment during their final months.
  4. Holistic Approach:
    • Hospice embraces a holistic approach, addressing not only the physical aspects of care but also the emotional, social, and spiritual needs of the patient and their loved ones.
  5. Respect for Individual Wishes:
    • Hospice encourages individuals to express their preferences and make decisions about their end-of-life care, respecting their autonomy and dignity.

Choosing hospice care is a deeply personal decision that involves considering the individual’s medical condition, prognosis, and personal preferences. By understanding when hospice is recommended and the reasons behind it, individuals and their families can make informed choices that prioritize comfort, support, and dignity during a challenging time. Hospice care serves as a compassionate and comprehensive approach to end-of-life care, focusing on the quality of life in the face of a terminal illness.

Hospice Quiz

November is National Hospice and Palliative Care Month!

Let’s test our knowledge and learn together!

True or False:

  1. Hospice is a 24/7 service.
  2. Hospice is only for 6 months even if you continue to live beyond that time frame.
  3. Hospice is only for cancer patients.
  4. Hospice services are paid for by health insurance.
  5. Hospice services include comfort and grief support for families after the patient dies.
  6. Hospice can be provided in nursing homes.
  7. Hospice is only appropriate if the person only has a few days to live.
  8. Patients on hospice cannot receive care from spouses, partners, children or other loved ones.
  9. Hospice helps by speeding up the dying process.
  10. Hospice cannot be provided in the home.
  11. Only persons older than 65 can receive hospice.
  12. Anyone can make a referral to hospice.
  13. Hospice provides medications, treatments, medical equipment and supplies that are related to the patient’s illness that is causing the need for services.
  14. Hospice ends when the patient dies.
  15. Hospice care is available to any individual expected to live 6 months or less.
  16. People who live alone are able to receive hospice.
  17. Hospice is designed to treat the emotional needs of the dying individual and their family.
  18. Dementia, such as Alzheimer’s disease, cannot have hospice.
  19. While on hospice, individuals can receive treatment such as chemotherapy, radiation, or surgery to cure the illness causing the need for services.
  20. Individuals on hospice cannot be taken to the hospital.
  21. Hospice care focuses on managing pain and symptoms.
  22. Hospice is for the caregivers, family, and friends, as well as, the patient.
  23. The Hospice team is a physician, nurses, social workers, and chaplains.
  24. Hospice is a minimum of 12 hours of daily bedside care provided by the clinicians.

Here are the answers:

  1. True
  2. False
  3. False
  4. True
  5. True
  6. True
  7. False
  8. False
  9. False
  10. False
  11. False
  12. True
  13. True
  14. False
  15. True
  16. True
  17. True
  18. False
  19. False
  20. False
  21. True
  22. True
  23. True
  24. False

Explanations will be in next week’s blog…stay tuned!

Pain is a disease

September is Pain Awareness Month.

Understanding chronic pain is critical to how we support our patients on our service.

Join us in our learning:

Pain Awareness Month – International Association for the Study of Pain (IASP) (iasp-pain.org)

September is Pain Awareness Month: Complexity and Progress in Pain Research | National Institute of Neurological Disorders and Stroke (nih.gov)

Pain Awareness Month 2023 – U.S. Pain Foundation (uspainfoundation.org)

June is Migraine & Headache Awareness Month

Our role in home health and hospice is to meet the needs of our patients where they are and help them achieve their goals. Managing the debilitating side effects of chronic headaches and migraines in the elderly is a unique skill that requires our attention for home health recovery and supporting the patient through symptoms while on hospice.  In the realm of home health, successful management of migraines is critical as there is an increased risk for stroke and other neurological symptoms if left untreated; in fact, poorly treated migraines often resulting in the severity intensifying which impacts quality of life (Curto et al., 2018).  Part of the management involves assessment of body weight, hydration needs, muscle/fat ratios, and albumin levels; each of these is vital in advocating for pharmacological solutions and identifying environmental factors which may be impacting the patient’s management of their condition (Wijeratne et al., 2019; Curto et al., 2018). Further, routine medication reviews address common challenges in the geriatric population for low treatment adherence resulting in suboptimal health outcomes (Wang & Wang, 2021). Addressing these concerns may result in further determination of other underlying conditions that may be a cause for headaches, such as elevated blood pressures (Wang & Wang, 2021).  Knowing these elements, aids providers in creating comprehensive strategies for their patients. Finally, medication reviews also help to address misuse of prescribed medications in the management of migraines in the elderly (de Rijk et al., 2017).  Home health completes regular medication reviews and access to healthcare professionals to train proper dosing and administration.

If you are looking to learn more, check out these resources:

https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/head.13247

https://link.springer.com/article/10.1007/s11916-021-00976-x#citeas

https://www.karger.com/Article/Abstract/494758

https://www.tandfonline.com/doi/full/10.1080/14656566.2018.1543660