Compassion, Quality, Integrity...
News • Social Services • Referral Info • Physician's Guide To Hospice • Physicians • Nursing Homes • Myths • Medicare/Medicaid • HIPPA Privacy • FAQ's • Diverse Diagnosis • Discharge Planners • Chaplains • Bereavement • Testimonials

Physician's Guide To Hospice

There are many reasons why physicians may delay a discussion of Hospice option with their patients and families:

There are convincing reasons to discuss Hospice services with the patient as soon as appropriate. Hospice care is most effective when provided over the period of several months. Nationally, thought, half of all patients die within one month of admission, while a full 20% die within the first week of care! While Hospice is usually able to control the physical pain of these late referred patients, it is stunted in its efforts to provide adequate spiritual and emotional support in such a limited amount of time.

Legacy Hospice offers these special features

  1. An educational commitment to physicians and other health care professional caring for the dying.
  2. Liberal patient admissions criteria.
  3. Contractual relationships with community nursing homes.
  4. Medicare / Medicaid-certified program.
  5. Care plan developed in cooperation with primary physician, with excellent communication and follow-up.
  6. Referrals welcome within 50 a mile radius.

Considering Hospice Referral:

If you think your patient is likely to die within six months, you next evaluate the patient's specific needs. An affirmative response to one or more of the following questions would properly trigger a call to a Legacy Hospice:

  1. Does the patient and family understand the seriousness of their prognosis?
  2. Are the goals of care changing? Would the patient prefer to spend more time at home with family and friends, pursuing activities while strong enough to enjoy them?
  3. Are pain management and comfort needs being addressed?
  4. Do grief issues need to be examined?

What Hospice Can Do for Your Patients

When your patient's illness has advanced to the point that curative treatments are no longer effective, hospice care gives you, your patient and the family another option. Hospice services do not replace your care-they supplement and enhance your relationship with a patient. Legacy Hospice offers an array of services, including pain and symptom management, assistance with personal care, feeding and light housekeeping, medical supplies, equipment and medication, bereavement counseling, professional social work, emotional support and spiritual counseling. Legacy Hospice's staff will consult with you to develop a plan of care that will build on your knowledge of an individual's situation.

When to Refer Patients to Hospice

There is no one moment when a patient's condition suddenly makes him or her hospice-appropriate. The course of an illness can be quick or gradual, and both physician and patient need to understand the reasons behind a referral to hospice. In general, hospice-appropriate patients meet the following criteria:

The six month rule

Physicians sometimes hesitate to recommend Hospice to their terminally-ill patients until it is too late for these patients to receive full benefits from this multi-faceted at-home care agency. One of the reasons for this hesitation may be the so-called "six months test" which asks, if the disease runs its normal course, will the patient die within six months? Physicians hesitated to make this pronouncement, saying they really cannot say how a particular individual will fare. Acknowledging the complexity involved, as a part of the Benefits Improvement Act of 2000, legislators revised this wording to send a more supportive message to physicians: "Terminal illness of an individual who elects hospice shall be based on the physician's or medical director's clinical judgment regarding the normal course of the individual's illness." (DHHS Program Memorandum 1/24/01). The memorandum also emphasizes the fact that patients can receive hospice services for longer than six months if they continue to meet the hospice criteria. Perhaps it would be helpful for the physician to ask him/herself this question: Would I be surprised if this patient was dead within six months? If the answer is "No. I would not be surprised," then that patient may be a candidate for Hospice care.

Diagnoses that May Qualify

Signs and Symptoms to Look For

Why You Remain Part of the Care Team

Once you have referred your patient to Legacy Hospice, you will become a valued member of the Hospice Team. You will sign an initial certification order, review the hospice plan of care, prescribe medication for comfort care, and sign the death certificate. The hospice nurse or medical director will be in regular contact regarding pain and symptom management, changes in the patient's condition and any needed visits or phone calls. With the regular visits of nurses, nurse aides, social workers, volunteers and counselors, the patient and family receive significant education in the treatments and medications your prescribe. Side effects or complications can be noted immediately, and changes ordered with your input.