When should hospice discussion begin? - page 3

note: i originally posted this in the critical care section with some reads and no responses so i posted here. thanks! i am a nursing student (pre-licensure bsn) and have been impressed by the... Read More

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    I am a hospice nurse that works in a local hospital, doing admissions and followups on current patients that come in.

    The hospital system I work with has a "Quality of life" team. They have patients all through the hospital, but they sit in on the "grand rounds" in the ICU. The qlife team works closely with the hospice team, often referring patients to us.
    The qlife team says there are "buzz words" for patients, and doctors routinely write for consults for them if the patient is: on a vent, over a certain age, multiple hospitalizations for the same issues. Not all qlife patients make it to hospice, but it's a good stepping stone.

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    I have just about finished my book on hospice. In researching it, there is one study that is just getting underway that expects that over 1000K patients annually are DBA or Die Before Admission to hospice. One, literally in the ambulance from the hospital to the home.

    Another study when I was just getting started in hospice found that 78% of patients who qualify for hospice do not get admitted.

    The answer, similar but sooner than what Used Nurse said, we should be talking about it in our young adulthood. When people get closer to their mortality they are more reluctant to speak about it.

    Even in nursing school, I was taught a number of misconceptions about hospice. Although this has probably changed, no wonder so few actually want it.

    And the best part, every year in my last job, we would have to fire about 4-6 patients because they no longer qualify for hospice. Some have other terms for this but the bottom line, they got better with our care.

    This is because hospice helps people live the last days of their lives. Some, a very few, perhaps just change their mind about dying.

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