Hospice Explainer: Despite the great care that hospices provide, they can represent an unfamiliar concept for patients.
“Hospice is a place where people living with a serious, life-limiting, or terminal condition can receive care focused on comfort, dignity, and living as fully as possible. Typically, people receiving care in hospice need help managing symptoms as they approach death and through the dying process.”
- Vancouver Coastal Health
Despite the great care that hospices provide, they can represent an unfamiliar and scary concept for patients. If this leads to undue hesitancy about hospice transfer, patients and their families may experience unnecessary distress, caregiver burnout, and/or hospitalization as a result. A compassionate Goals of Care conversation is the most important piece for hospice, but below is information that may be useful to consider for patients with questions.
- Hospice eligibility criteria:
Life-limiting illness with a prognosis of short months. - Goals of care focusing on quality of life and accepting the natural dying process. This means in large avoiding the potential harms associated with further transfers and hospitalization.
- Care manageable within the hospice environment. Examples of patients who require care beyond what hospice can provide include violent / exit-seeking patients or patients dependent on IV medications (we can often find an oral or subcutaneous alternative!).
Hospice logistics:
- Patients can book tours of hospice ahead of time to familiarize themselves with the environment.
- Referral to hospice is typically done through the Home Health team in the community. Once the patient is referred to Home Health, they can facilitate the necessary paperwork and the community nurses can activate palliative care assessments/supports as appropriate. Patients will typically have their care optimized with home supports before hospice transfer is found to be necessary.
- Completing paperwork ahead of time will expedite transfer, but wait times can still commonly be a week or longer.
- Temporary respite stays can be facilitated in some circumstances if patients / caregivers require it despite optimal use of home supports.
- Transferring patients to the hospital can be facilitated in some circumstances for procedures that would provide symptom relief.
- Day passes are supported as long as patient safety is not a concern.
- Overnight visitation is typically facilitated.