“My father has had several hospital stays over the past few months, and he seems to be getting worse. How do we know if it’s time for hospice? What signs should we look for?” – Bryan from Alpharetta

I am sorry to hear about your father’s declining health, and I understand how difficult a decision it is for families to choose hospice care for their loved ones.

Many people do not realize that hospice is not only for patients with a terminal illness but may also be an option for patients who fail to thrive, or experience decline because of several disease processes or deteriorating health. Families may also be unclear about what services hospice care covers and how a hospice care team focuses on a patient’s comfort and dignity. Let’s explore a bit more about what hospice care is and how to know when it may be time for hospice.

What Is Hospice?

Also known as end-of-life care or comfort care, hospice care provides for a patient’s medical, emotional, and spiritual needs. It includes a team of physicians, nurses, caregivers, and even spiritual leaders to help a patient transition from curative treatment to symptom relief. Hospice services can take place at home or in a facility, and patients receive a treatment plan tailored to their needs.

Remember, hospice is not a place; it’s a service. 80% of hospice care takes place in the home or other residence such as a nursing home or assisted living facility. Only 20% of hospice patients receive their care in an inpatient hospice setting, and most hospice companies do not even have a designated inpatient hospice facility.

Medicare and most insurance plans cover hospice care services, which can include these benefits:

  • Nurse visits one to three times a week and 24/7 on-call access
  • Participation of patient’s physician or hospice physician director
  • Social worker services
  • Home-health aide for hygiene several times per week
  • Medication management
  • Durable hospital equipment and medical supplies, including incontinence products
  • Respite care
  • Counseling services
  • Laboratory or diagnostic testing as appropriate
  • Additional services and therapies, depending on the hospice company’s policies

Another hospice benefit that can help is grief counseling after your loved one’s passing, which can be a comfort to your family at a difficult time. You or your family can determine which hospice provider works best for your senior’s needs, and you do have choices. If you work with an Aging Life Care Manager, they can recommend hospice services in your area.

Some families do not understand when it is time for hospice and may miss out on receiving the full range of benefits. Every family should discuss when and if to call hospice to make the end of life as comfortable and dignified as possible. Having the conversation is not a commitment to using hospice care but rather another aspect of life planning, like having a will, power of attorney, or other advance directives.

How To Tell It Is Time for Hospice

Now that you have a better understanding of all that hospice care can do, how do you know when to consider these services? Look for these signs to guide you when it is time for hospice care for your elderly loved one:

  • Frequent emergency room or hospital visits
  • Recurring infections
  • A rapid decline in health, even with medical treatment
  • Weight loss or lack of interest in eating
  • Uncontrolled pain or shortness of breath
  • More confusion
  • Decreased alertness
  • Increased sleepiness
  • Inability to carry out activities of daily living, including feeding, dressing, bathing, or ambulating
  • A diagnosis of a life-limiting illness
  • A desire to focus on the quality of life rather than aggressive treatments

If several of these signs become evident for your loved one, you may want to consider discussing a transition to hospice care. It is not a sign of giving up but rather a proactive step of choosing how to spend the rest of your loved one’s days in comfort, love, and dignity.

I understand that hospice is not an easy decision for any loved one, but it may be a choice made with love and kindness. Hopefully, by talking about which services can provide the most benefits for your senior, you can determine when it is the right time for hospice care.

Best of luck!


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