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From the Neighborhood Press

A smiling and friendly doctor talks to a patient about their chart in their hospital room to discuss care options

When Is Hospice Care Usually Ordered By A Doctor?

Hospice is a specialized way to provide dignified and compassionate end-of-life care to people with a terminal illness. A doctor can order hospice care if they believe that a patient has six months or less to live if their illness follows its expected course.

Caring for a loved one with an end-of-life illness can be an emotionally draining and challenging experience. Learning about what hospice can provide in the early stages of a terminal condition can help minimize stress when the time comes that a doctor recommends hospice care.

Why Would a Doctor Order Hospice Care?

Hospice care manages symptoms and discomfort in order to try to maximize a person’s quality of life and minimize their suffering. While doctors aim to treat illnesses, this is not always possible. Doctors recommend hospice care in cases where:

  • A patient’s illness has progressed to a point where curative treatments are no longer effective.
  • The patient expresses a desire to stop aggressive treatments.
  • When the patient has experienced multiple hospitalizations or emergency room visits in a short period. Frequent hospital trips can indicate that the patient’s condition is worsening and that a different approach to care may be needed.

This decision is based on medical evaluations and the patient’s condition. Many patients and their families prefer to spend their remaining time in a familiar, comfortable environment rather than in a hospital setting. Hospice care can also provide the assistance necessary for managing symptoms, and offers emotional and spiritual support.

When Should Hospice Be Called In?

While doctors can recommend hospice care, it is often the patient or their family who first express a desire to focus on quality of life rather than the pursuit of aggressive treatments. This shift in priorities usually signifies that the patient and their loved ones are ready to explore end-of-life care options.

Often, the progression of the patient’s illness and their declining health is a key factor in such a mental shift. This can include the patient experiencing:

  • Uncontrolled pain
  • Frequent infection
  • Significant weight loss
  • A decreased ability to perform daily activities such as eating, bathing, or dressing

Hospice care can provide necessary support for the activities of daily living, and can help ensure comfort and dignity.

When Should a Patient Be Admitted to Hospice?

Admission to hospice care is based on specific criteria set by healthcare professionals. One of the primary factors is the patient’s prognosis. If a doctor determines that the patient has six months or less to live, they may recommend hospice care. This decision is made after thoroughly evaluating the patient’s medical history, current condition, and response to previous treatments.

Another criterion for hospice admission is the presence of symptoms that are difficult to manage with standard medical care. These symptoms may include severe pain, difficulty breathing, nausea, and emotional distress. Hospice care teams are specially trained to address these issues and improve the patient’s comfort and quality of life.

It is also essential to consider the patient’s wishes and goals for their care. If the patient prefers to spend their remaining time outside a hospital, hospice care can provide the necessary support to fulfill this wish.

How Do I Know My Loved One Is Ready for Hospice?

Recognizing when your loved one is ready for hospice care involves observing changes in their health and quality of life. One of the most telling signs is a significant decline in their physical and mental abilities. If they’re struggling with basic daily tasks and require constant assistance, it may be time to consider hospice. 

A depressed older adult in a blue shirt is comforted by a friend

Other signs your loved one may be ready for hospice include:

  • Increasing need for medical intervention (frequent hospitalizations, emergency room visits, complex treatments, etc.)
  • Unpleasant side effects from current medical treatment
  • Increased time spent sleeping 
  • Decreased alertness
  • Expressing feelings of hopelessness 

How Do I Know that I Am Ready for My Loved One to Be in Hospice?

It can be difficult to acknowledge that your loved one is ready to receive end-of-life care, especially if you’ve been the one caring for them. However, many people tend to self-sacrifice their needs to provide this care—a choice that can lead to caregiver burnout

You may be ready for your loved one to be in hospice if you experience:

  • Guilt for being unable to attend to your other family members
  • Frequent bouts of being overwhelmed by financial, legal, or spiritual issues
  • An inability to make plans due to uncertainty regarding your loved on
  • Physical and/or emotional exhaustion from providing care

It’s important to remember that it’s not selfish to take care of yourself. Your loved one may even be concerned about burdening you with their needs and wishes for you to be well.

What if Their Condition Improves?

Hospice care is not a one-way path. Patients can be discharged from hospice if their condition stabilizes or improves to the point where they no longer meet the criteria for hospice care. If this occurs, the patient can return to receiving standard medical care and treatments as needed. Additionally, if their condition later declines again, they can be readmitted to hospice care. 

It’s also worth noting that many patients experience an improved quality of life while receiving hospice care due to the comprehensive support and symptom management provided. This improvement can sometimes lead to a temporary stabilization of their condition. The focus is always on providing the most appropriate care based on the patient’s needs and wishes.

Haverland Carter understands that deciding when to consider hospice care for your loved one is a deeply personal and challenging decision. Contact us today to see how we can help make your loved one’s remaining time as meaningful and comfortable as possible.

A smiling and friendly doctor talks to a patient about their chart in their hospital room to discuss care options

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