Although end of life care may be difficult to discuss, it is best for families to share their wishes long before it becomes a concern. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes that advice and input of physician, family members, and loved ones.
Most patients and families who receive hospice care say they wish they had known about it earlier, that they needed the help much sooner than they received it. Research has shown that hospice can increase both the quality of life and how long a patient lives. Families who receive hospice near the very end–just a few days to a week–have been shown to have a harder time adjusting during the bereavement period than do those whose loved one receives hospice care for weeks and months before passing on. If you even think that your family and the person you care for could benefit from pain or symptom management, assistance with bathing and grooming, emotional and spiritual support, and telephone access to caregiving advice, ask your physician if hospice might be a service to consider.
Experts agree that at least two to three months of care is optimal. It is better to ask sooner rather than later so you do not regret having missed the support that hospice has to offer.
When the burden of treatment outweighs the benefits and/or the patient has had multiple hospitalizations over the last several months, he or she might be ready for hospice. Other indications include:
- Repeat trips to the emergency department
- Unrelieved pain
- Frequent infections
- Sudden or progressive decline in physical functioning and eating
- Weight loss/difficulty swallowing
- Shortness of breath/oxygen dependence