As your patient no longer responds to curative treatment or would benefit from a philosophy of care focused on comfort and support, this is the time to consider Residential Hospice. Patients, their families and physicians should consider hospice after a diagnosis of a life-limiting illness and when hospital admissions, tests and treatments are detracting from the patient’s quality of life. A patient does not have to be bed-bound or critically ill to receive hospice services.
Signs Your Patient May Meet Hospice Criteria
- Your patient is a “frequent flyer” to the hospital.
If your patient rotates in and out of the hospital, it’s time to refer to hospice. To begin, your patient probably would rather stay at home and be comfortable. You may in fact hear your patient say that he or she doesn’t want to go to the hospital anymore. With hospice, instead of calling 911, patients call their Residential Hospice nurse, who talks through their issue with them or makes a visit. We keep patients in their own homes to manage their pain and symptoms. Did you know 80% of people in the United States die in the hospital? We make sure our patients pass in their home with their loved ones surrounding them.
- Your patient says how tired they are of therapy or they sleep through therapy.
If your patient with Parkinson’s, or any other patient, says that they are tired of therapy and want to be left alone, it’s time to refer to hospice. You may also see a loss of muscle mass or shortening in length of endurance. When patients come to Hospice, we continue their exercises, our Home Health Aides perform range of motion techniques, and we continue to walk them if they are able.
- Your patient does not want to eat or drink as much and/or they are losing weight.
If your loved one said they were thirsty, you would probably get them a glass of water. If your loved one said they weren’t thirsty, why wouldn’t you honor their wish? At the end of life, patients are not able to metabolize substances like they used to. Did you know studies show that patients who were hydrated just before passing are in more pain than those who let their body run its “natural course”? If you see a weight loss of 10% body weight in the last 6 months, or a lack of interest in food, it is time to refer to hospice. All of the above are signs that the body is preparing for something.
- Your patient has increased pain.
Another term for hospice is “Comfort Care.” Our nurses are experts in managing pain so that our patients can live pain-free and have a high quality of life.
- Your patient has declined in their Activities of Daily Living.
If your patient can no longer dress, feed or bathe him or herself, it is time to refer to hospice. You may also find they are now incontinent, suffer from dyspnea and are having difficulty walking.
- Your patient sleeps more during the day or has sleep disturbance at night.
If your patient is sleeping more during the day and is agitated or suffers from anxiety, hospice can help with shifting their sleeping patterns to become more regular.
- Your patient has increased confusion or forgetfulness.
If your patient has an inability to speak six or more words in a given conversation, it is time to refer to hospice. Any changes in cognition can be a red flag.
- Your patient is refusing to take their medications.
This is an indication that the patient’s “treatment goals” have changed. Similar to the hospital, medications are considered treatment. Patients have the right to choose not go to the hospital or take their medications. This is their way of choosing hospice even though they may not know it.
- Your patient has had increasing edema, sepsis or aspiration pneumonia in the last year, or stage 3 or 4 decubitis ulcers.
These are all indications that a change is happening in your patient’s health and therefore a referral to hospice is necessary.