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Referring a Patient to Hospice

Who should be referred for Hospice Care?

Any patient who has a life threatening illness with a prognosis of 6 months or less if the disease runs its normal course and is not receiving curative treatment should be referred to Hospice for supportive care. Hospice cares for and has expertise in the care of patients with many life-limiting illnesses and conditions, including but not limited to:

  • Adult Failure to Thrive - multiple organ failure, multiple ER visits, unintentional weight loss (10% in 6 months), decline in health
  • AIDS - increasing infections, self-care deficits, continued weight loss/weakness, medication no longer effective
  • Alzheimer's Disease - difficulty swallowing, inability to speak, dress, or feed self, loss of bowel and bladder control, progressive weight loss
  • ALS (Lou Gehrig's Disease) - impaired swallowing/breathing, self-care deficits, muscle wasting rigidity, progressive weight loss
  • Heart disease - severe fatigue, dyspnea at rest, chronic fluid buildup, frequent hospitalizations
  • Respiratory/pulmonary disease (end stage) - disabling dyspnea, poor control of symptoms, O2 dependent, frequent hospitalizations
  • Stroke - coma or persistent vegetative state, irreversible damage, inability to swallow, need for total care
  • Cancer

This is a sample list only. See the Medicare Coverage Database - Disease Specific Guidelines

Referring a Patient

Early Referral = Better Quality of Life

Often the patient's family or friends make the first call. Although, a minister, parish nurse, rabbi, friend, or even a next-door neighbor, can make the first call to Hospice.

Before actual admission, the patient's physician must certify that the patient is medically appropriate for hospice care. Hospice will contact the physician to obtain this verification, if the patient desires Hospice care.

The earlier a patient is referred, the more Hospice can do to help. Sadly, many people believe that hospice care is unavailable or inappropriate until the patient is confined to the home or bed. A great deal can be done, however, many months earlier to improve quality of life. Hospice can provide:

  • Expert pain and symptom management
  • Emotional and spiritual support to patient and loved ones
  • Assistance in organizing a patient's personal affairs
  • Help in how to talk about the many difficult issues that arise at end-of-life
  • Help in dealing with unresolved issues that block communication
  • Support for the caregiver

Early referrals improve the quality of the patient's life with the above interventions. The patient is more involved in making decisions; this in turn helps the family know that those difficult choices they need to make are what the family member desires. Decisions can be made before it is a moment of crisis.