According to the National Hospice and Palliative Care Organization, of the more than 1.71 million Medicare beneficiaries who were enrolled in hospice care in 2021, 50 percent received care for 17 days or less, 75 percent received care for 79 days or less, and just 10 percent received care for more than 264 days. Yet, a typical response among families is that they wish they had started their loved ones on hospice sooner.
What can hospice offer a family? For many, it is more time. Research shows that starting hospice sooner is best, as patients tend to live longer. To dive deeper into why families should start hospice sooner, we sat down with Dr. Jeffrey Boggess, a retired physician and board member at Hospice of Redmond.
“In Oregon, hospice is a free benefit available to people diagnosed with a terminal illness with a prognosis of six months or less to live,” said Dr. Boggess. “This six-month window can be extended because patients can live longer.”
Dr. Boggess explains that many people think they won’t qualify for hospice until late in their lives. Patients are often referred to hospice through their primary care provider, specialist, or a memory care facility. Yet others self-refer.
Self-referring patients and families need to understand that hospice doesn’t mean a person has weeks to live. They also need to know how hospice benefits both the patient and the family.
“Families do better because they get help and respite care,” said Dr. Boggess. “Patients do better because they get all the services they need.”
Dr. Boggess recommends that anyone with a terminal diagnosis contact hospice despite their prognosis.
“One benefit of reaching out to our team for an evaluation is that families receive education on what hospice is and the available services,” Dr. Boggess stated. “If a person is not qualified initially, they are now in the system and don’t have to wait for an intake. When qualified, they can begin hospice right away.”
Hospice is not all or nothing.
Hospice isn’t a light switch that you turn on or off. It isn’t all or nothing. If a person is not ready for hospice, there are options, which is why it is so important to begin the process early. When someone does not qualify for hospice, they likely qualify for Transitions or Palliative Care.
“Families often do not know what their family members need in terms of services and help, but they can get this and supportive counseling, bereavement services, and more through all of the programs offered at Hospice of Redmond,” said Dr. Boggess. “We have an entire staff trained to support and advocate for families wherever they are in the journey.”
Transitions is a free non-medical program that supports people through the mental, physical, and emotional changes that often accompany a life-limiting illness. Through the program, individuals and their families can gain access to community resources, non-medical assistance through trained volunteers, and even respite care.
Palliative care is specialized medical care for people with chronic or life-limiting illnesses. This program helps individuals maximize their quality of life. Transitions and Palliative Care services may be offered concurrently, depending on the individual’s needs. People on Transitions or Palliative care may continue to receive curative treatments for their life-limiting illness if they so choose.
Most patients want to stay at home.
The hospice model delivered through care facilities has built-in manpower for the care a person receives right off the bat. However, many patients want to stay at home, so they choose a care provider in their home. That person, often a family member or friend, can become overwhelmed quickly.
“The ability to have volunteers and nursing care come in and spend time with the patient frees up the primary caregiver,” said Dr. Boggess. “The biggest advantage to these programs is that the patient can stay at home, and I strongly believe that the longer a person can stay in their home, the better.”
In-home care from a trained professional relieves the patient and their family of care responsibility and provides appropriate resources for their current needs. That said, whether a patient chooses to remain at home or if their home is a facility, hospice provides needed support for the patient, their family, and their facility.
Reaching out does not mean a person is giving up.
“We tend to be avoidant when dealing with death,” said Dr. Boggess. “It is something that happens to someone else, but then it happens to us, and the family is overwhelmed, and a patient is reluctant to ask to be at home because the family thinks they can’t handle it.”
In-home care supports the patient and their family. Often, when a patient says yes to care earlier rather than later, their life is extended. The barrier is often making the call or asking the primary care provider.
“Making the call doesn’t mean they are giving up or letting go of any chance of recovery,” said Dr. Boggess. “I have patients who come to hospice, and a year later, they are still around because of the consistency in care and quality of care they receive.”