How will I or my family know when it’s time to consider hospice?

Individuals who have had some of the following may be eligible for care.

1. Frequent hospitalizations.
2. Weight loss.
3. Decreased ability to care for oneself.
4. Recurrent infections requiring medication.
5. Advanced cancer no longer responding to therapy.
6. Refusing dialysis or wanting to discontinue dialysis.
7. Advanced dementia with loss of ability to speak.
8. Shortness of breath at rest due to heart or lung issues.
9. Rapidly deteriorating conditions from chronic illnesses.
10. Those with neurological disease such as Parkinson’s Disease who have had a decline in function.

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Hospice Eligible or Hospice Appropriate? What is the difference?

There will be times when we evaluate patients who are eligible for hospice care based on the Medicare Guidelines but feel they are not yet appropriate for hospice. For example, someone with advanced incurable cancer who is no longer a candidate for therapy and has had a drastic decline in function may be eligible for hospice. But what if he or his loved ones still choose to be Full Code meaning CPR will be attempted? What if the family still wants a feeding tube or I.V. Fluids? What if they still want to be hospitalized? Is he appropriate for hospice? In this case, because the focus does not appear to be comfort and quality of life, we would need further discussions to ensure that hospice is the right choice. We want our patients and their families to feel they have made the right decision when accepting our services.

 

Some difficult choices to make when considering hospice.

1. Do Not Resuscitate or Full Code? – CPR (cardiopulmonary resuscitation) was developed in the 1960’s to rescue victims of accidental “sudden death” such as drowning victims, electrical shock, or when an otherwise healthy person experienced a heart attack. CPR is not meant for those who are terminally ill and want to die with dignity. Research has shown that there is a less than 2% survival rate for those with a terminal disease when receiving CPR. If they are somehow revived, they will be in worse condition than before. Is this something you or your loved one would want?

2. Artificial Nutrition and Hydration – Families and friends gather for meals for many occasions. In some cultures, it is customary to offer food to anyone walking into their home. When a patient can no longer take food or fluid by mouth, the immediate reaction for some is putting in a feeding tube or giving intravenous fluids. Families feel they are starving their loved ones by not “feeding them.” That is not the case at all, and it is a natural part of the dying process to stop eating. Here are some facts about artificial feeding and fluids.

Facts about tube feeding:
It places the patient at risk for aspiration pneumonia.
It does not prolong survival.
It does not prevent bedsores.
It does not provide comfort nor improve quality of life.

Benefits of NOT using feeding tubes or I.V. fluids.
Less fluid in the lungs therefore, less congestion making breathing easier.
Less fluid in the throat.
Less pressure around tumors, therefore less pain.
Less urination, therefore, less need to move the patient.

A natural release of pain-relieving chemicals occurs when the body is dehydrated, resulting in a sense of well-being.

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3. Should we stop the medications? – There comes a time when the medications people take are no longer of benefit or may even cause harm. Research has shown that stopping certain medications such as cholesterol medications did not affect life expectancy. When the focus has changed to quality of life in the terminally ill, limiting the medications to those that are truly beneficial is the best thing to do for yourself or your loved one.

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4. Do I need to use the hospice affiliated with my hospital or nursing home?

No. You have the right to choose any hospice agency.

**Why choose Neighborhood Hospice out of the many options available?

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1. We understand that having a hospice conversation can be difficult.  We take time to educate patients and their families so they are comfortable with their decision to accept our services.  

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2. We are straightforward and honest about the services we offer.  Hospice is for those who have a terminal illness, and if you are told otherwise, you have been misinformed.

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3. We do not offer monetary incentives to our staff or anyone else to find patients.  For this reason we do NOT employ marketers or liaisons to sell hospice.

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4.  We will not waste your hospice benefits as we only have the best interest of our patients in mind.

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5. We focus on providing excellent care to our patients and their loved ones. Our team only takes care of a few patients (below the industry standard) so they can spend time with you instead of rushing off to see the next patient.