Caregiver holding hands with hospice patient

When to Call Hospice?

Hospice is a really tough decision for any caregiver or family to make. It’s important to make sure you have all the information before making a final decision on moving forward with hospice care. The first thing to learn is about what hospice is and how it will benefit your loved one. Next, you will want to explore what all the options are when considering hospice care. Finally, you will want to know when to call hospice.

If you are considering hospice, it can typically be a tough time for you and your family. You might have doubts if hospice is the right way forward or if you are considering hospice too soon. Understanding all of the care options can give you some comfort that you are making the best choice possible.

What is Hospice? 

You might have heard of the word hospice before, but might not know exactly what it is. Hospice has been around for over 50 years. Dame Cicely Saunders, an English nurse, established the first modern hospice in 1967. She focused her new philosophy on palliative care, a type of holistic treatment of individuals with serious illnesses. Palliative care focuses on pain management, symptom reduction, and improving their quality of life. Using the idea of palliative care, elderly loved ones with terminal illnesses or chronic pain are made comfortable in hospice care. Hospice care is not about prolonging or hastening death. It’s about providing the patient with dignity, care, comfort, and love near the end of their life.

Types of Hospice Care

The overall goal of hospice is to take care of your loved one by providing them space where all of their needs are met. However, there are four types of hospice care, or “levels of hospice.” It’s important to understand each of these levels so that you can make a more informed decision. 

Routine Home Care 

This is the most basic hospice care available. A care team, consisting of a physician, nurses, bereavement counselors, volunteers, and more, will do what they need to help you and your loved one with accommodations in your home. The goal is to provide for your loved one in a space they feel comfortable. This is convenient for you as the caretaker because you get to be home, or at your loved one’s home, so everyone is in a familiar environment.

Continuous Home Care 

Continuous home care takes place in your home as well; except with this level of hospice care, a nurse will stay in the house for an extended period if your loved one is experiencing a severe episode or having extreme chronic pain. This way, instead of having rotating and visiting staff, like with routine home care, you can have a consistent presence. This helps remove some of the caretaker’s medical responsibilities, allowing you to attend to the social side of your loved one’s care. Having a nurse at your side can help you navigate the next best care steps for your loved one.

General Inpatient Care 

This level of hospice care is intended to be a quick, symptom release in a hospital, so your loved one can return to their home. If your elderly family member experiences an extreme medical crisis or has severe pain episodes, they may benefit more from a short stay in a hospital. Health teams can quickly try to mitigate their symptoms so that they can return to their homes.

Respite Care 

This may be the most important level for you as a caregiver. Respite care is a form of hospice care which provides a break for unpaid family caregivers. Feeling overwhelmed as a caregiver is very normal. Respite care is an excellent option if you are overwhelmed by the responsibilities of providing 24-hour, around-the-clock-care. Respite care can be given for an afternoon or up to several weeks.

When is it Time to Call Hospice? 

Now, armed with new information, comes the hard part. How do you decide when to call hospice? This decision may be tough because it may come with feelings of intense guilt. However, it’s essential to understand that your elderly family member’s needs could be beyond your scope, and hospice could be the best way forward. This is a tough decision, but you’ve done the research and clearly want the best path forward. Below are a few scenarios on when it may be best to consider moving forward with hospice: 

Your Loved One Has Been Given Six months or Less to Live 

Hospice care is usually prescribed for those who have been given six months or less to live. Their disease or pain is no longer treatable or curable, and it is time to transition them to care that will help make their pain and symptoms more manageable. Cancer patients, especially, should consider these options when no form of treatment has been proven to be helpful anymore. 

You or Your Loved One Has Decided to Forgo All Treatments 

When treatments are not working, and pain and suffering are high, it may be time to consider hospice treatment. The last thing you want is for your loved ones to keep going through brutal treatments or harsh interventions that make the end of their lives unbearable. Unless there is a notable improvement in their symptoms, then you may want to consider other options. It’s not giving up when the treatments weren’t working anyway. 

The reassuring thing about hospice care is that is isn’t the end-all to your loved one’s treatments. You can always re-enter them into advanced treatment programs if that is a decision that your team comes to (the team being physician, elderly patient, family, and other necessary personnel). Consider your loved one’s state of being and their happiness. Thinking about the quality of your loved one’s life and less about the longevity of their life is an excellent exercise to put yourself through. One, you may have control moreover than the other.  

You Don’t Have the Skills or Resources to Provide the Best Care  

Hospice care has medical advantages that are hard to ignore. Terminally ill, elderly patients require a lot of attention, medication for pain management, and potential interventions during intense crises. If you are not equipped to handle this, you may feel overwhelmed and could even prolong your loved one’s issues.

How to Bring up Hospice Care as an Option

Sometimes, hospice care is a touchy subject because physicians, patients, and family members may have a hard time coming to terms with it being the best option. Therefore, there may be a delay in when it is mentioned, but bringing up hospice care sooner rather than later can be very helpful in giving your loved one as many more good days as possible.

If these are your loved ones last few months spending time with you and your family, you will want them to have some great last moments. If your physician is hesitant, then there are ways to bring this up, especially if it’s something you have been considering. One good way is to ask about it as an option and request more information. It’s a tough transition and comes with some challenging realities. But at the end of the day, hospice is about improving the life of your elderly family member. Take time to talk about it with everyone involved, and use the information above to help you make the best decision.  

Sources:

  1. What Is Hospice Care?, American Cancer Society, www.cancer.org

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