Is It time for Hospice?

Posted by Hospice by the Bay on Mon January 13, 2014 in Talking About Hospice

by Dr. Margaret Bourne, Hospice by the Bay Chief Medical Director

Dr. Margaret Bourne

Dr. Margaret Bourne

Most people want to be cared for at home during the last year of life. Hospices help millions of Americans reach this goal each year. However, many people don’t ask their doctors about hospice care early enough. So many of our patients tell us, “Your care and support has been so wonderful, we wish we had called you sooner.” Too many people spend their final months in and out of the hospital with medical crises, missing the opportunity to die at home with hospice’s compassionate support.

So what is hospice and when is the right time to choose hospice care?

Hospice care is provided by a team of professionals who help the patient, their family members and caregivers cope with the unique demands of coping with the end of a life. This caregiving team includes medical directors, nurses, social workers, home health aides, spiritual support counselors, trained community volunteers and grief counselors. The comprehensive approach is designed to meet the medical, physical, practical, spiritual and emotional needs of patients, while offering vital support for families and caregivers.

Hospice care is not an end to the patient’s treatment, but a shift to comfort-oriented care that is focused on improving the quality of life. Hospice care does not hasten the end of life, nor prolong life past its natural end.

Hospice care is provided wherever the patient calls home — a family residence, a care facility or the hospital. Medicare, Medi-Cal and most insurance companies cover hospice care with no cost to the patient, including medications, medical equipment, supplies and regular visits from the hospice team.

Eligibility under the Hospice Medicare Benefit, as defined by the federal Medicare Hospice Benefit, begins when a doctor determines a patient has six months or less to live. Unfortunately, many doctors refer patients too late, only days before death, when they could have benefited from the extra support of hospice care for six months or more. We recommend that doctors, patients and families discuss hospice at the time of the terminal diagnosis, so patients can consider this option as soon as they are eligible.

The conversation about end of life care wishes and support should be ongoing. Advance care planning is an option that can give patients the opportunity to explore and document their care wishes and understand all the options available. Members of the hospice team can help with this process. When the patient is ready, there are many positive reasons to choose hospice care. Since its goal is to ensure patients’ dignity, comfort and quality of life, many patients’ conditions improve because of the personalized support of our caregiving team. These patients can then leave hospice care, and, if they wish, return to curative treatment. For those who die while in hospice care, while hospice care didn’t change the outcome of their illness, it improved the quality of their lives during their final months.

To help you decide whether it’s time to consider hospice care, see the questions below. If the answer is yes to three or more, call Hospice by the Bay to discuss options. We can help you think through what’s best for you and your family.

Have you or a loved one:

  1. Been hospitalized several times in the last six months?
  2. Used medication more frequently to ease pain symptoms?
  3. Needed help with two or more of the following?
    • Bathing
    • Dressing
    • Eating
    • Walking
    • Getting out of bed or a chair
  4. Had unexplained weight loss in the last year?
  5. Had shortness of breath while resting?
  6. Been diagnosed with a serious illness by a doctor and told that life expectancy is limited?

No matter how you answered these questions, please contact us anytime to learn more about Hospice by the Bay’s care and support.

To download a printable pdf of this article, click here.

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