What Determines When a Person Goes on Hospice?
When is it time to start having a conversation about hospice? It's a question that thousands of families around the country are struggling with. As of 2020, there are 1.5 million hospice patients in the United States. The truth is that there's no neon sign that goes off to make it obvious when it's time to shift your approach to hospice. However, there are subtle signs that can make it clear that a different level of support is needed to move forward with providing a loved one with the comfort and safety they deserve. Here's a look at the factors that help to determine when a person goes on hospice.
What Determines if You Are Ready for Hospice?
So, how do you know when it's time to go to hospice? Here are some signs and factors that doctors consider when they recommend hospice care.
1. The End of Treatment
In some health journeys, there comes a time when treatment is no longer working. A patient may also "make the call" to stop aggressive interventions in favor of simply savoring the quality of life they have for the moment. Hospice care is most often used in the case of a terminal or untreatable illness. The pivot to hospice represents a decision to focus on gently managing symptoms and providing pain relief instead of attempting to cure or reverse illness or disease. Hospice is often recommended at the end of treatment for:
- Cancer
- Heart or lung disease
- Kidney or liver failure
- Alzheimer’s/dementia
- Stroke
- Amyotrophic lateral sclerosis (ALS)
What triggers the hospice conversation in these types of cases? Generally, hospice will be introduced to the conversation once a doctor decides that life expectancy is six months or less based on the natural progression of the illness being managed.
2. Recurrent Infections
When a person is having recurrent infections, this represents entry into a danger zone that requires a more elevated form of care. Chronic infections and poor wound healing are signs that a person needs around-the-clock supervision. Hospice is often recommended when a person develops sepsis or recurring urinary tract infections (UTIs). If a person has become inactive due to an illness, bed sores pose risks for infection when regular turnings aren't being initiated.
3. Frequent Hospitalizations
Frequent visits to the emergency room that result in hospitalization can signal that hospice is needed. If a person has multiple visits to the emergency department in a span of six months to a year, it's time to speak with a primary care physician about a better option for managing severe health issues. For older adults, frequent non-routine doctor visits and hospital stays can signal declining health.
4. Communication Breakdowns
When a person can't communicate, they can't advocate on their own behalf. This is why declines in speech and hearing are signs that it may be time for hospice. A person who begins to withdraw from daily activities may also benefit from the support of hospice.
5. A Person Is Spiraling Toward Confused
Hospice isn't just there to help manage a person's comfort during acute illness or disease. A person experiencing cognitive decline can also benefit from the support and stability offered by hospice. Unfortunately, rapidly declining cognition doesn't just isolate a person from their loved ones and friends. It also poses serious risks. As cognition declines, people become more susceptible to hallucinations or delusions that could cause them to act out. This can include things like leaving the house unsupervised in the middle of the night, leaving gas burners unattended in the middle of cooking, or becoming violent while believing that neighbors or family members are trying to harm them.
6. Overwhelmed Caregivers
As disease or age-related declines progress, family caregivers often become overwhelmed. They simply don't have the tools to continue caring for their loved one in a way that is safe for everyone. Caregivers undergo extreme stress. One study found that more than 60% of people tasked with caregiving say that it increased their levels of stress and worry. By pivoting to hospice, family members and caregivers can remain present in a loved one's life without carrying the burden of handling medical tasks they simply aren't equipped to perform.
7. Sleep Occupies Most of the Day
A person sleeping most of the time is a sign that hospice should be strongly considered. Excessive sleep can be part of the body's natural process of slowing down at the end of life. This is a time to pivot to ensuring a loved one's comfort as they embrace their final days.
Final Thoughts
There should never be shame or hesitation surrounding the conversation about hospice care. Hospice care is a gateway to dignified care that can incorporate symptom management, pain management, spiritual support, and emotional support. If your family is ready to learn more about taking the next steps for hospice care, contact our team today to learn about the comfort that's possible.
