Health Care Providers
As a health care provider your focus is to keep your patients well and healthy through out their entire lives. Inevitably, some of your patients’ lives will come to an end. As their health care provider you will have to help them through this final transition.
An AMA Public Opinion Survey found that 74% of Americans expect their physicians to be confident and competent to provide them with care should they develop a life threatening illness.
A Gallup study found that while 90% of the respondents expressed a wish to die at home, in reality 80% of Americans die in an institutional setting.
Health care providers receive little formal education in end of life care and consequently such care is introduced too late to be fully effective. Hospice would like to share with you some tools to help relieve suffering and improve the quality of life for all those living with, or dying of, a life limiting disease. These resources can help you better understand end of life care and what you can do to help your patients with this last transition.
Some of the major questions physicians face when treating a terminally ill patient are:
• When is it time to refer the patient to Hospice?
• How do you make a Hospice referral without taking away hope?
When is it time to refer a patient to Hospice?
To be eligible for Hospice care a patient must meet the following criteria:
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They have a prognosis of 6 months or less if the disease runs its normal course |
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The patient has stopped curative treatment and they desire palliative care |
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There is a qualifying functional decline |
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It is often difficult to state with certainty that there is a 6 month prognosis. In many cases it is helps to focus on patient’s functional decline as the guideline for referring patients to Hospice. For more information on when to refer patients to Hospice click here to download an Adobe Acrobat PDF file. |
How do you make a Hospice referral without taking away hope?
Dr. Charles F. von Gunten, Center for Palliative Studies, San Diego Hospice, recommends the following steps when discussing Hospice care:
• Establish an appropriate setting for discussion
• Ask the patient and family what they understand
• Find out what they expect will happen
• Discuss overall goals and how Hospice will help achieve them
• Respond to emotions
• Establish and implement the plan
The entire text of Dr. von Gunten’s article, “Discussing Hospice Care”, as it appeared in the Journal of Clinical Oncology can be found by clicking here.
Resources
National Hospice and Palliative Care Organization
www.nhpco.org
The NHPCO is dedicated to leading and mobilizing social change for improved care at the end of life.
Center to Advance Palliative Care
www.capc.org
CAPC is dedicated to increasing the availability of quality palliative care services in hospitals and other health care settings for people with life-threatening illnesses, their families, and caregivers.
American Academy of Hospice and Palliative Medicine
www.aahpm.org
AAHPM is an organization for physicians who are committed to furthering and fostering the practice of hospice/palliative care for the terminally ill and their families.
American Pain Society
www.ampainsoc.org
APS is a non-profit multidisciplinary educational and scientific organization dedicated to serving people in pain, through research, education, treatment and professional practice.
Growthhouse
www.growthhouse.org
This web site is an international gateway to resources for life threatening illness and end-of-life issues.
Americans for Better Care of the Dying
www.abcd-caring.org
ABCD is a non-profit coalition of citizens and professionals united to ensure that public policy addresses the needs of individuals and families coping with a fatal illness. |
