When to Call in Hospice – How to Know When It’s Time

By Cheryl Culbertson

Hospice care is generally designed to help patients who know they are dying control their pain, stay comfortable, and get their social, emotional, and spiritual needs met in a supportive environment.

Hospice care is often seen as a last-resort option-one to use when the patient no longer can benefit from traditional medical care. The fact is that approximately twice as many older Americans end their lives in hospital care now than they did ten years ago-but hospice is still seen as a last resort. If it was brought in sooner, it could do patients more good.

However, studies show that more and more, hospice is being used as the option of last resort for patients who receive very aggressive hospital care during their final days-care that may not be appropriate. For many patients and families, hospice care may be a better option earlier in the care process-skipping the aggressive intensive care that often occurs at the end of life.

1. When your doctor says there are few other options. Usually, the doctor and the patient decide together when it is time for hospice care. In general, hospice care is recommended when the patient has approximately six months to live if the illness follows its natural course. But the timing can be different for different patients.

However, hospice is primarily designed for end-of-life care. Hospice care should be considered when the doctor is saying there is little else to be done, but before a health emergency puts you in the critical care ward at the hospital.

2. When living at home is no longer an option or has become too difficult to do alone. If you or a loved one has been living at home while managing a terminal disease, the health situation has continued to decline, and living at home has become hard, it may be time to consider hospice. Hospice can be helpful for those who can no longer manage activities for daily living, such as chores, cooking, showering, dressing, and basic hygiene tasks, and who have no one to help them on a regular basis-or those who need the type of round-the-clock medical care that a family member is not qualified to provide.

3. When your pain cannot be managed effectively. If you or a loved one is in a great deal of pain from a terminal disease and pain medication needs have become overwhelming, it may be time to consider hospice care. In hospice, trained medical professionals monitor patients' pain and can closely observe them, making it possible for pain medication to be more carefully adjusted to accommodate the patient's changing needs.

Choosing hospice is never easy. However, hospice care can make the difference between a stressful, negative end-of-life situation and one that is more comfortable. Consider asking your doctor about hospice sooner-for yourself or for a loved one-and hopefully, you'll be able to get the care you need.

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