¿Es el momento para recurrir a cuidados de hospicio? 3 preguntas para hacerse
El cuidado de hospicio proporcionado en el momento óptimo brinda a los pacientes el obsequio del tiempo. Pueden aceptar su diagnóstico, pasar un tiempo compartiendo recuerdos, despedirse, poner en orden sus asuntos y concentrarse en su calidad de vida hacia el final.
Un cuidado de hospicio óptimo y oportuno también brinda un respiro a los profesionales de asistencia médica, los cuidadores y los familiares que enfrentan crisis, estrés y los desafíos de síntomas cada vez más graves y de determinadas situaciones, a medida que el paciente decae.
¿Es momento de considerar el cuidado de hospicio? Answering these questions can help:
1. Is the patient facing one of these life-limiting diseases or conditions?
The most common disease and conditions associated with hospice care, according to the National Hospice and Palliative Care Organization, are:
- Cancer (28%)
- Cardiac and circulatory diseases (19%)
- Dementia/Alzheimer’s (17%)
- Respiratory diseases (11%)
- Stroke (9%)
Other conditions include end-stage liver and kidney disease, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease) and other degenerative neurological diseases.
2. Is the patient or loved one showing these signs of decline?
The following factors are good indicators that it’s time for hospice:
- A doctor has certified the patient has six months or less to live if the condition/disease follows its normal course
- Curative treatments (medications, chemotherapy, rehab, etc.) are no longer effective or create side effects that prolong suffering, discomfort and pain
- The patient has decided to stop testing, hospitalizations and treatments in favor of palliative care
- The patient is increasingly unable to perform the activities of daily living (personal hygiene, dressing, eating, maintaining continence, transferring)
- Over 4–6 months, the patient has experienced any of these:
- Loss of 10% or more of body weight
- More than 3 hospitalizations or emergency room visits
- Presence of other co-morbid conditions
- Declining physical activity
- Declining mental alertness/cognition
3. Have you taken the patient’s wishes into consideration?
A patient's preferences for end-of-life treatment will be spelled out and easy to follow if they have an advanced care plan (ACP). This includes a living will, durable power of attorney for healthcare, or (in some states) a Five Wishes document. If the patient has made it clear that certain procedures or interventions should or should not be pursued in the face of a life-limiting illness, the hospice team can craft a care plan that honors the patient's wishes while focusing on the quality, not the quantity, of time that remains.
If you have questions about hospice appropriateness, contact the admissions department of a local hospice. The staff should be able to answer questions or send a clinician to evaluate the patient and meet with the family at no cost. Aided by this information, you'll have a better sense of when the time is right for hospice care.