By Barbara Hansen, RN
“We wish we
had been put on hospice sooner,” is one of the most common responses hospice programs hear from patients and their families.
We have found that often the barrier to accepting hospice as a form of care during a life-limiting illness is the patient not wanting to give up and admit they were going to die soon. One of the paradoxes about hospice is often people on hospice actually live longer than those who have the same diagnoses and are not receiving hospice care.
In order to receive hospice care, a physician must “certify” that a patient has a terminal illness with a prognosis of six months or less. The six-month prognosis is not a time limit for how long someone can remain on hospice. It is, rather, a “rolling” six-month expectation. If a patient lives past the initial six month estimate, the patient’s physician, along with the medical director of the hospice program, must “recertify” every two or three months that the patient continues to have a life expectancy of six months. Hospices work with physicians to determine if a patient meets prognostic “markers” to continue to qualify for the hospice benefit.
There continues to be a widespread belief by the general public, as well as some health care providers, that medications used to relieve symptoms may shorten a person’s life. But there is an equally widespread belief among hospice workers that being on hospice can actually help patients to live longer and often with a higher quality of life!
In 2007, a study was published in the Journal of Pain and Symptom Management addressing the differences in survival periods of terminally-ill patients between those who used hospice and those who did not. The researchers studied five types of cancer diagnoses as well as congestive heart failure. For these six different patient populations combined, the mean survival period was 29 days longer for hospice patients than for non-hospice patients. This study showed that for certain terminally-ill patients, being on hospice can actually result in longer survival times.
To learn more about hospice care or about grief education programs, please contact the Samaritan hospice service
Barb Hansen, RN, manages patient care at Samaritan Evergreen Hospice.