How can I start receiving hospice care if I have cancer?

In order to start hospice services, a physician must sign a "referring order" that certifies that the patient's life expectancy is six months or less if the advanced cancer runs its expected course. If a person in hospice care lives longer than six months, hospice benefits can be continued if a physician states that the person's life expectancy is still less than six months. The health care team or an oncology social worker can help you find out what hospice care is available in your community and how to arrange for it.

Hospice care is a misunderstood health care benefit. If your cancer is growing despite good treatment, have a discussion with your oncologist or primary care provider about actively managing your troubling symptoms, which can and should be done during treatment, not only afterwards. If you have reached a point where the treatments are making you sicker and not better, hospice care can provide comprehensive care for you and your family at home, in the hospital, in a skilled nursing facility or a hospice residence, making the focus of your care specialist level management of your symptoms and distress.

Hospice is a separate benefit in most medical plans, and is often mistaken to be helpful only in the last days or hours of life. Hospice care can be provided when medically necessary for a condition that is likely to be terminal within six months "if the disease runs its usual course." Care is centered on the family at home, with the backup of hospitals or respite units. Care may be provided by your own doctor without interruption. Medications, supplies, some home health aide time, pastoral care counselors or social workers, even physical therapy and nutritional help are all available when it is part of your plan of care.

You can self-refer or ask your primary care provider to help. More information about hospice as part of a plan of care for cancer is available in LEARN to Live Through Cancer: What You Need to Know and Do, published by Demos Health.