Dear Barbara, how do you get a terminally-ill patient to accept hospice care?
Most of us know hospice takes care of people who are dying. Since we are a death-denying society, no one wants to hear that they need hospice services.
You may be wondering who counts as “people who are dying” and at what point people can be considered to be “dying.” These are people who the doctors are having a difficult time fixing; people the doctors probably can’t fix. What does hospice do? Hospice helps these patients live as comfortably as possible with the understanding that they won’t be cured. Hospice also provides reassurance and practical assistance to families of the patients.
What do you say to someone to get them to accept hospice? Well, one thing to consider asking after explaining the services hospice offers is what they think will happen if they get on hospice too soon. The answer is often a really good thing – the person gets discharged from the hospice program. They have stabilized or gotten better and no longer need the guidance that hospice offers. Great! Eligibility is addressed for two 90-day periods and then a 60-day period. But you can apply for numerous 60-day extensions after that.
Getting on the hospice program when a person’s condition is deteriorating in spite of all the treatment that has been given means accepting a different kind of medical help. It is not saying we have given up hope. It is not implying that death will be tomorrow or next week.
What is so bad or scary about that? The scary part is that everyone has to admit, on paper, that there isn’t going to be the cure everyone was praying for, that life isn’t going to end with a “happily ever after.” Hospice services can support and guide everyone during that scary time.
So how do we get someone who needs it on the hospice program? Talk with them about all of the above. The hard part then will be to stand back and let them make their own decisions. It may not be the decision we think is best for them but at least it will be based on fact not fear.
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