Why weren’t we told about Hospice sooner?

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director

Ramona Visiting Nurse Association and Hospice

Question: "My husband just passed away at home on Hospice after a long battle with Alzheimer’s disease. We didn’t know about Hospice until the last week my husband was alive. Why weren’t we told about Hospice sooner?"

Unfortunately, many patients who would benefit from comprehensive end-of-life care are never offered Hospice and often the option of Hospice is not discussed until the last few days of life. Most Americans surveyed report that they would prefer to die at home; but over 75% die in Hospitals or Nursing Homes. The typical Hospice patient is on service less than 3 weeks; with one in three patients receiving fewer than 7 days of Hospice care and one in ten patients not being enrolled until the last day of their life.

There are many factors that contribute to late Hospice referrals. In one study 60% of families interviewed had no knowledge of hospice prior to their first hospice program explanation. More than 90% of those families enrolled in Hospice after receiving information regarding the comprehensive services available. 74% of families who felt that they were referred to Hospice later than desired had received fewer than 3 weeks of services; which suggests that 3 weeks might serve as a minimum amount of time necessary to address end-of –life issues.

The Medicare Hospice Benefit provides comprehensive medical, nursing and bereavement services to dying patients and their families. Patients are eligible for Hospice when their doctor determines that they have a life expectancy of six months or less. Although your doctor may recommend a particular Hospice, patients have the right to select the Hospice which they feel will best meet their needs so long as the Hospice is Medicare Certified.

My grandpa used to say that only two thing in life are certain, death and income taxes. Although I can’t offer much help with your taxes, if you or someone you know would like to learn more about Hospice, please call our Healthy Elder Life Program at 1-888-983-5337; or visit us on the web at www.help4elders.info.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.