Hospice indicators: Signs a patient could benefit from hospice care

Hospice care is reserved for patients who are facing a life-limiting illness, but there are more signs a patient could benefit from hospice care than you may think.

Oftentimes, physicians possess misconceptions about hospice care, like that hospice is only for the last few days of life. But contrary to popular misconceptions, this is not the case.

The truth is that patients facing a terminal illness can receive care and support for six months or longer depending on the course of the illness. And it’s common to hear patients and their loved ones say they wish they had known about and started hospice sooner to help them understand what to expect during the end of life, control pain and symptoms, and receive needed support.  

By recognizing hospice indicators and early signs a patient could benefit from hospice care, a physician can introduce a new philosophy of care dedicated to prioritizing comfort and quality of life.

What is hospice?

Hospice is not a place, but rather a philosophy of care. It focuses on providing compassionate care so people can live as fully and comfortably as possible in the last stages of their disease. 

End-of-life care does not try to hasten or postpone death. Instead, it provides physical, psychological, spiritual and emotional support to the patient and their loved ones.  

Hospice coverage includes:

• Interdisciplinary care team
• Medications related to terminal illness
• Durable medical equipment (DME)
• Spiritual care for patients and loved ones
• Pain relief and symptom management
• Medical, nursing and social services
• Aide and homemaker services

How do patients qualify for hospice care?

To be eligible for hospice care, a physician must certify a patient has a life expectancy of six months or less if their disease were to run its natural course.

The Medicare hospice benefit covers the cost of care for a patient’s terminal illness and related conditions. It covers hospice care for two 90-day and unlimited 60-day periods, if no revocations or discharges occur.

A homebound requirement is required only for Medicare home health services. Hospice patients are encouraged to experience as much as possible and are able to continue participating in the activities they love, such as attending church, visiting family and even traveling out of town.

Hospice indicators

As mentioned, hospice care is not just for people who have a life expectancy of a few days. It is intended for people who are diagnosed with a terminal illness and have a prognosis of six months or less.

While this list is not extensive and doesn’t cover all terminal diagnoses, common hospice diagnoses include:

• Cancer-related diagnosis
• Heart disease
• Pulmonary disease
• Dementia
• Stroke
• Renal disease
• Liver disease
• HIV-AIDS
• ALS
• Parkinson’s disease

Each disease may have specific indicators for a prognosis of six months or less, but there are a few indicators that terminal illnesses share in common.

Ask yourself, do you have a terminally ill patient with any of the following indicators? If so, it may be time to for them to begin hospice care.

• Functional decline
• Extreme weight loss
• Multiple comorbidities
• Decreasing serum albumin
• Increased infections
• Increased hospitalizations
• Dependence in most activities of daily living (ADL)
• Karnofsky Performance Status or Palliative Performance Scale of less than 50%

Benefits of early intervention in hospice care

There are many benefits to beginning hospice care early. Whenever patients can be cared for in the comfort of home during the last few months of life, they experience a dedicated focus on comfort, more quality time with loved ones and less time spent in and out of the hospital.

Focus on dignity and comfort

The purpose of hospice care is to focus on pain and symptom management, allowing patients to receive end-of-life care that is consistent with their wishes. If your patient has been undergoing treatment for quite some time and the negative effects are outweighing the positive, it might be time to discuss options outside of continuing treatment.

When a patient’s symptoms can be minimized, their comfort and quality of life can be maximized, improving their quality of life for the rest of the time they have left.

More time with loved ones

Over half of hospice patients are only on hospice for 30 days or less, according to the National Hospice and Palliative Care Organization. Whenever patients know about the benefits of hospice care sooner, they could get more quality time with their loved ones.

Even if your patient has a prognosis of 12 months or more, it’s a good idea to start an early conversation about hospice care. Without your knowledge and support, they may not know that hospice care could bring them more quality time with their loved ones at the end of life.

Less time spent in the hospital

Whenever a patient is facing a terminal illness, it is common that they might experience unaccustomed symptoms. This new onset of symptoms might lead to more frequent trips to the emergency department to check vital signs.

A hospice care team can often prevent trips to the emergency department. With full-time and on-call nurses available 24 hours a day, they can address and manage the symptoms that arise so patients can spend less time in the hospital and more time wherever they call home.

Loved ones are supported before, during and after the end-of-life journey

The benefits of hospice extend far beyond increasing a patient’s quality of life as they near the end of life. Hospice care provides bereavement services for the family beginning as soon as a patient chooses hospice and for typically 13 months after the patient’s passing, with the ability to receive extended support if needed.

This may provide an extra layer of comfort to a patient, knowing their loved ones will be well supported after they pass.

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At Enhabit, our referral process is as streamlined as possible, allowing physicians to refer patients quickly and easily, providing them with a smooth transition of care. If you have a patient in your care that is showing signs they could benefit from hospice care, learn how to refer them to Enhabit today.

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