When Is It Time To Call Hospice?

Recommending hospice to a patient often means concluding that medical interventions designed to halt or slow their illness will no longer be effective. But predicting end of life is a very inexact science, as each patient is unique, and the exact progression of their illness is difficult to predict.

Compounding those factors, of course, is the challenge of initiating the hospice talk.

Is It Time for Hospice?

If a patient exhibits signs that suggest that their disease will progress regardless of continued or additional medical intervention, it may be time to consider hospice.

Signs that suggest hospice care could be warranted include repeated hospital visits/stays, increases in pain or other disease symptoms, declining alertness or emotional capacity, and growing need for assistance with walking, eating, bathing, dressing, or going to the toilet.

The American Academy of Family Physicians has a list of tools for determining prognosis in terminally ill patients. The tools include:

  • Karnofsky Performance Scale
  • National Hospice Organization Medical Guidelines for Determining Prognosis in Selected Non-Cancer Diseases
  • Palliative Performance Scale
  • Palliative Prognosis Score

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