When to refer a Patient to Hospice Care

When to refer a Patient to Hospice Care

Phyisicans and other healthcare providers should consider referring a patient to hospice care if they have been diagnosed with a life-terminating illness or if death is expected within the next 6 months. In the event that life-prolonging treatment is no longer the primary goal, but rather comfort care is, then a patient should be referred to a hospice care program.

A patient may be referred for one of the following reasons:

  • assessment
  • consultation
  • advice
  • direct patient care
  • support
  • assistance with discharge planning

What diseases can be referred to for hospice care?

Hospice care was originally designed for those who were nearing the end of their lives. It has thus evolved into a medical discipline that focuses on a broad variety of serious or life-threatening illnesses in the last decade.

According to the World Health Organization, “all individuals have a right to high-quality treatment during serious illness and to a dignified death, free of severe agony and in accordance with their spiritual and religious convictions.”

Hospice care is available to patients with cancer, heart disease, chronic lung disease, AIDS, Alzheimer’s, multiple sclerosis, amyotrophic lateral sclerosis (ALS), end-stage kidney disease, and a variety of other serious illnesses.  Pain and symptom management is one of the main objectives of hospice care so to improve quality of life.

Hospice care can help you optimally carry on with your activities of daily living as best as possible until your last day, and it can also increase your capacity to endure your condition’s associated pain by giving relief for a variety of ailments.

General criteria for referring to hospice

The patient is officially diagnosed with a progressive, life-threatening disease and one or more of the following:

  • Based on diagnostic and prognostic assessment, the patient does not have longer than 6 months to live.
  • The patient and/or the family have psychological, social, or spiritual problems that need to be evaluated by a professional.
  • The patient is dying, and the primary care staff needs some extra help and/or counsel.
  • The goal for the patient’s care is no longer life-prolongation but rather comfort.

Referral triggers for hospice care

Some common triggers that may show the need for referrals are listed below;

  • The referring practitioner suspects the patient will die within 6 months.
  • Recurrent hospitalizations.
  • It is clinically suspected that the patient may die during a hospital stay.
  • Condition worsens despite life-prolonging therapy.
  • Available therapeutic options have a no chance of effectiveness.
  • Cessation of life-prolonging treatment, or discussion of withdrawal of life-prolonging treatment (for example hemodialysis, ventilation, etc.).
  • Concerns about end-of-life complications among families/relatives
  • Physical function has recently deteriorated significantly.

When can I begin to receive hospice care?

Hospice care can begin at any point during illness, even immediately you receive a diagnosis, so long as the your provider suspects that you have less than 6 months to live and you are not seeking life-prolonging treatment but rather comfort care. Hospice care should be started as soon as possible to alleviate the negative effects of your illness, pain, and other associated symptoms. Hospice care specialists are aware of the pressures you and your family are experiencing and can assist you in coping to mitigate the possibility of depression or anxiety.

If you or a loved one are seeking to live your last days with comfort, discuss and request a referral to hospice care from your doctor if believed to be appropriate.

References

Jennifer Robinson, August 16, 2019. When Is Palliative Care Appropriate?

Retrieved from: https://www.webmd.com/palliative-care/when-is-palliative-care-appropriate

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