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Who Should Initiate Hospice for a Senior?

by Ellen Coughlin, End-of-Life Expert
May 25, 2012

Question: Should I wait for our physician to raise the possibility of hospice for my grandmother, or should I raise it first?

Answer: The answer to this question is “yes,” you should absolutely raise the issue of hospice care for your grandmother to her physician. While this certainly isn’t an easy topic to approach, you will find that introducing it to the doctor will lead to an open and honest discussion about your grandmother’s condition and prognosis. From my experience, most family members wish they would have brought up the issue sooner because they would have had the opportunity to benefit from the help and support hospice offers much earlier in their loved one’s illness.

I am often asked by families, “Why didn’t our doctor bring up hospice or offer it as an option?” Physicians are people, too, and many have their own reluctance to accept death and dying. Some often become extremely close to their patients, making it difficult for them to initiate a conversation about end-of-life care. They have to transition their goal from that of facilitating a cure, to a focus on comfort and symptom management and this can be difficult for him/her personally.

Bringing up hospice to the doctor gives him/her a “green light” to redirect the care plan. While it is never easy for a family member to ask the question about end-of-life options, more often than not, the doctor is waiting for it to be asked.   

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Ellen P. Coughlin, RN, MPA, MA, CHPN, has been the Vice President of Patient and Family Services for Barnabas Health Hospice and Palliative Care Center, a Barnabas Health facility located in northern New Jersey, since 1997. Currently serving as a Board Member for the New Jersey Hospice and Palliative Care Organization (NJHPCO), Ellen is also a member of the NJHPCO’s Pediatric End-of-Life Care Committee/Quality Partner Committee.

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