Once you’ve determined that hospice care might be the best course of treatment for one of your patients, it’s time to formulate a plan to discuss hospice care and arrange for a hospice consult. Making that recommendation can be easier said than done, especially since hospice care has many connotations that go along with it. What do you need to know about hospice care for your patients?

What Is Hospice Care?

Whenever someone is facing a life-limiting illness, the goal of their medical care should be a team-oriented approach to care, pain management, emotional support and spiritual support that is customized to the patient. In surveys, many caregivers and families of terminally ill patients indicate that they would have liked information about hospice care when the diagnosis was labeled as terminal, not later in the process. While communicating this might not be comfortable, you should keep this in mind.

Delivering Bad News

One of the best methods for delivering bad news in the medical field is SPIKES. SPIKES represents a 6-stage process: set up, perception, invitation, knowledge, emotion and summary.

• Set Up: Choose the right environment for the discussion and ensure medical consensus beforehand.
• Perception: Ask the patient what they know about the illness and any information they already know. Ask the patient what matters most to them and what their wishes are. You should also ask if the patient has heard of hospice care and what they know about it.
• Invitation: Ask the patient if it’s okay if you share information about hospice care with them.
• Knowledge: Provide the patient with information before the hospice consult. Let the patient know that hospice can help them meet their goals of staying at home instead of going to the hospital, pain management and emotional support. Also, let the patient know what hospice care provides.
• Emotion: Express sympathy for the patient. For example, “I know this isn’t good news to hear,” or “I’m sorry that I have to be the one to tell you this.”
• Summary: When patients get a lot of information at once, it can be hard for them to process things. At the end of the conversation, ask the patient what they understood. You should also state clearly your recommendation that the patient have a hospice consult so they understand what the next step should be.

Recommending a Hospice Consult

You should determine whether or not a patient is eligible for hospice care. Medicare mandates that patients have a life expectancy of 6 months or less if the illness runs the expected course. You must be able to certify the terminal diagnosis and prognosis or re-certify them. To obtain a hospice consult, you must request it from a hospice service provider. The provider will evaluate the patient, determine eligibility and establish a care plan.

Practice Guidance for Your Practice from Vetters Enterprises

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