Monday, July 16, 2012

How Do You Know When to Contact Hospice?

A reader writes: My mother died this past December and my dad has been in the hospital since mid-December. They are releasing my dad this week and we are searching for a nursing home. Here is my problem: My brother and his wife feel very strongly about getting hospice involved. (They live in another state and are not here to help me.) We waited too long with my mom and she died before we contacted hospice. I am not getting any opinion from my dad's doctor about how much time he has left, and I realize they don't know that for certain. My question is how do we know when to contact hospice? Can they help us if my dad is in a nursing home? What exactly would they do, if my dad is in a nursing home? My brother wants to find an in-patient hospice, but I don't know if that is the way to go. Any advice or information you can tell me would be great. Thank you so much.

My response: Your question about hospice is not at all unusual. Most of us don't even think about such matters until circumstances force us to do so. Not all doctors are informed about hospice and end-of-life care, either, so I'm glad you came here with your questions, and I'll do my best to help.

First, I suggest you do a bit of reading, so you'll feel more certain about the course of action you decide to take. I don't know where you live, but I invite you to begin by exploring Hospice of the Valley's website, where you will find a great deal of useful information. See, for example, these pages:
I also encourage you to visit Hospice Foundation of America's website. See especially these pages:
As to your specific questions: 

How do we know when to contact hospice?
You can contact hospice at any time, simply because you want to discuss future plans. In order for your dad to be placed in hospice care, our present health care system requires that you have a physician's certification that your dad is in need of hospice care. But the hospice you select will be able to guide you in how to go about obtaining that. (If you live outside Hospice of the Valley's catchment area, you can locate a hospice service in your own community here: Find a Hospice)

Can they help us if my dad is in a nursing home?
As stated on HFA's Web site, "Hospice is not a place but a concept of care. Eighty percent of hospice care is provided in the patient's home, family member's home and in nursing homes. Inpatient hospice facilities are sometimes available to assist with caregiving." When you contact both a hospice and a nursing home for your dad, state that you are anticipating the need for hospice services for your father, and ask how they would go about providing such services in their facility.

What exactly does hospice do, if my dad is in a nursing home?
This depends on what your father needs, based on a thorough assessment by the hospice team. Once you call in a particular hospice, someone from that service would meet with you and your dad to conduct such an initial interview and assessment, and then they would present you with whatever they recommend.

My brother wants to find an in-patient hospice, but I don't know if that is the way to go.
Your father may not be in need of this level of care just yet. Again, this is best determined by the hospice team who would conduct the initial assessment.

For further information, including answers to frequently asked questions about hospice and palliative care, visit the Choosing a Quality Hospice page at CaringInfo, a program of the National Hospice and Palliative Care Organization.

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© by Marty Tousley, RN, MS, FT, DCC  [Updated September 4, 2017]

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