Hospice care can be discussed at any time. Often, the discussion about hospice services takes place when the patient and his or her loved ones learn that:
- The cancer is no longer treatable and that additional therapies will not provide any benefit
- Life expectancy may be six months or less
- A physical decline and exhaustion are likely to be permanent
- Treatment is no longer desired by the patient
Many physicians hesitate to bring up the subject of hospice because they do not want patients to think that they have given up. There may come a time when you think that hospice care should be considered, but are not sure how to start this conversation. If this is the case, a member of the healthcare team can help you define what options are available.
Sometimes the patient is ready to consider hospice care before his or her loved ones are. In other cases, the family may want to start services. Often, the decision is made together by the patient and his or her loved ones. If you are struggling with the decision about hospice care, talk to a healthcare provider, oncology social worker, licensed counselor, or member of a faith-based organization about your feelings and concerns.
It is generally the patient’s right to make this decision unless he or she is unable to communicate. However, if a patient cannot communicate his or her wishes, a spouse or other family member may be asked to decide. The healthcare 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.
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.
