When Doctors Recommend Hospice & Loved Ones Aren’t Ready

Determining whether a patient is physically ready for hospice is a simple process. Assess the patient. Review the hospice eligibility criteria. If there is a match, make the hospice referral. Easy, right? If life was black and white, making a hospice referral would be the easiest decision in the world. However, when you add emotion into the equation, it can be anything but easy.

“The family isn’t ready.”

Too often physicians share that, although the doctor recommends hospice, the family is “not ready for hospice care.” In many cases, the reason for this is a misunderstanding about what hospice is.

Families often believe that hospice care is only used when their loved one has only a few days or hours left to live. This incorrect assumption can result in their loved one missing out on months of extra support and care.

Explaining the benefits of hospice and the fact that their loved one is eligible when they still have six months left – if their illness takes its usual course – can help them to understand that hospice is not about dying. It’s about living your days with the highest possible quality of life.

Getting to the Heart of the Matter

When a family pushes back when a doctor recommends hospice, it can be tempting to delay the conversation, hoping that they’ll come around on their own. But to truly ensure that the patient receives the care that they need, it is important for physicians to have a deeper conversation.

Asking families about their concerns can yield a wide range of answers:

• We don’t want to give up hope.
• She’s not ready to die yet.
• We can’t afford that care.

Understanding the specific concerns of the family allows physicians to address each one.

If the family shares that they want to keep hope alive, physicians can review the diagnosis with the family and help them come to terms with the fact that all possible treatment options have been pursued. It can be helpful to share that a patient can stop hospice care at any time if a new treatment option becomes available to them.

If the family believes the patient is not ready to die or that they’re not ready to let go, that’s okay. Hospice will not shorten their loved one’s life span. It will merely provide extra support so they can make the most of their time together. We’ve seen hospice patients attend weddings, take off on hot air balloon rides, and enjoy rock concerts. We don’t want patients to simply be alive for a few more months – we want them to live their best life every day of it.

Concerns about cost are the easiest to address. Hospice care is covered at 100% by Medicare, Medicaid, and most insurance companies. This coverage applies to not just the care provided, but to any medical supplies, equipment, or medication related to the patient’s terminal diagnosis.

Let us help.

If a family says they’re not ready for hospice care, physicians don’t have to shoulder that conversation alone. Crossroads Hospice & Palliative Care staff are happy to address family concerns. We can assess the patient for future care or even help to mediate family meetings about their loved one’s plans for the future.

Making a hospice referral early means the Crossroads team can start that conversation and meet the patient to get a baseline on their current health while giving the family some ideas of things to look for that may indicate a decline or unaddressed pain.

If a patient is not yet eligible, we can also provide palliative care support hand-in-hand with other treatment options so the patient is able to meet with a nurse practitioner and social worker a few times a month to address changing symptoms.

To see hospice eligibility requirements or to make a hospice referral, please call 1-888-564-3405.

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