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Steps for Getting Hospice Care for Your Loved One

by Viki Kind, End-of-Life Expert
August 11, 2011

Question: How do I get my significant other into hospice? He has colon cancer that has spread everywhere, and his pain is not being managed. The oncologist doesn’t seem to want to talk about hospice but I think it is time. What can I do?

Answer:

I am sorry that you are both going through this.  It’s not right that he is in this much pain.  But, the good news is that you can solve this problem today.  If the oncologist won’t make the call to get hospice started, you can call any of the other doctors he is seeing and ask them to put him on hospice today. 

My aunt was put on hospice with just one phone call.  I didn’t need to take her in to see her primary care doctor.  I just called and asked the primary care doctor to make the referral to hospice.  Because her doctor knew how sick she was, he got the hospice team in place right away.  (FYI: An emergency room doctor can also put someone on hospice.)  Do not give up.  Keeping calling and asking for help even if it takes a number of phone calls.

If that doesn’t work, you can call your local hospice company and ask the medical director, (the doctor who is in charge of the hospice), to come out and evaluate whether or not your significant other qualifies for hospice.  To qualify for hospice, there is a list of signs and symptoms the doctor needs to see in order to receive these services.  If the medical director thinks he qualifies, then she can call the oncologist or primary care doctor directly to get the referral to start hospice. 

After the doctor makes the referral, a hospice representative will call you later that day or the next morning. A social worker and a nurse will be coming out to see what your significant other needs and what your family may need.  (The hospice team does not provide full-time care, however.) Then you will start receiving visits from other hospice staff and deliveries of medical supplies such as a hospital bed, oxygen and other necessary supplies. You will also be receiving medications to take care of his pain and other symptoms.

Regarding his pain problems:  The hospice team should be able to get his pain under control and to help him get the care and services he needs.  Pain management is one of the things hospice does best.  Another option for pain management is to ask for a referral to a palliative care doctor.  Whether a person is dying or not, he or she is entitled to good pain control and palliative care doctors are the experts in this area.

Your significant other’s quality of life should improve dramatically when his pain gets under control and hospice is in place. Many people on hospice live longer and better because the care is so good.  Please take care of yourself as well.  The caregiving journey can be exhausting and overwhelming.   

For more information about hospice go to the Hospice Foundation of America:  http://www.hospicefoundation.org/

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Viki Kind is a clinical bioethicist, professional speaker, and hospice volunteer. Her book, The Caregiver’s Path to Compassionate Decision Making: Making Choices For Those Who Can't,” guides families and professionals through the difficult process of advocating for those who can no longer speak for themselves. She has recently launched a DVD that includes a template to create a quality-of-life statement.

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