When is the right time to begin hospice care?


When patients reach the end of their lives, hospice care plays an important role in their plan.

Planning for end-of-life care can be such a difficult process — particularly for family members — many people delay needed care that could relieve painful symptoms that allow patients to spend their final days more peacefully.

In fact, one study published in the Journal of the American Geriatrics Society found that only 43 percent of participants were admitted to hospice in their last year of life, with a median duration of only 12.5 days in hospice.

However, as Dr. Thomas M. Gill noted in an article published by Consumer Reports, "When folks are referred to hospice only in the last days of their life, it’s difficult to have a meaningful benefit."

So how can patients and their families know when it's the right time to begin hospice care? Consider the following tips for how and when to make end-of-life care plans to ensure the best quality of life for you and your family.

Talk about hospice care early

It is never too early to open a discussion on end-of-life care for yourself or family members. Even if you are healthy now, talking about your wishes before hospice care becomes a concern can reduce stress and confusion down the road and help family members better cope with the transition.

The National Hospice and Palliative Care Organization suggests ways to prepare an advance care plan:

  • Share your beliefs and values with family
  • Outline your wishes concerning treatment and care

Additionally, by beginning these conversations in advance, you'll have the opportunity to educate yourself on your options and the types of care available to you and your family.

Take advantage of medical staff recommendations

Even if you have had discussions with family about possible end-of-life care plans, it can still be hard to know when to implement them. If you have been diagnosed with a serious and terminal illness, talk to your doctor about your options, and don't be afraid to ask follow-up questions, even if you've already asked them.

Your doctor is a valuable resource and should keep you informed about what to expect through treatment, the care options available to you, and any recommendations for maintaining the best quality of life, including if and when hospice care is right for you.

The doctor should also be able to offer a realistic estimate of the progression of the illness and recommend a hospice care timeline. If you haven't already, inform your family about your wishes. Your doctor can help explain your treatment and care plan as well as the benefits of hospice care.

Recognize the signs

Even with careful planning and communication, it can be difficult to know exactly when it is time to move from treatment to hospice care. Often the family or the patient wants to fight for recovery. Unfortunately, this is not always a possible outcome. Here are a few signs it is time for hospice care:

  • Treatments are no longer working, or are causing more pain and suffering than the illness itself
  • The patient is struggling to manage pain or other serious symptoms such as weight loss, fatigue or personal care
  • The patient wants to focus solely on quality of life
  • The patient made a care plan in advance that specifies when hospice care should be implemented
  • The family is feeling overwhelmed physically or emotionally, caring for their loved one

Typically, patients and their families should plan for hospice care following a terminal prognosis of six months or less under the direction of their physician. Exactly how long patients will spend in hospice will depend on their prognosis, overall quality of life and their personal desires for care.

While hospice care is sometimes a reality people prefer to ignore, planning for care now and learning about options will make the process easier for you and your family.

For more information about how hospice care works, click here or call our admissions and referrals line at  844.422.3648.