Published Aug 1, 2013
84RN
97 Posts
I'm a home health RN and fairly often we get patients that go to hospice care. Today a patient's daughter was asking me some questions because they're considering hospice for their mom.
How much is treated wrt medical issues, and does this vary from company to company? Would a uti be treated, or would that be seen as a normal course of physical decline? Pneumonia?
The family was told that they have to have a dr's order to initiate hospice, but I've heard otherwise---can they just call the hospice themselves for an eval?
How do you know when it's time to consider hospice?
Any other information you could give me to pass along to families and patients would be appreciated. I'm a big supporter of hospice care--my own father had a very positive hospice experience before his death, and have seen many patients benefit from it.
SuesquatchRN, BSN, RN
10,263 Posts
An order is needed for hospice admission.
A UTI will be treated as it is a comfort issue and can lead to sepsis. Pneumonia will be treated if the patient or POA/family want it treated. Antibiotics can be withheld if the patient of POA requests it. It is by no means done routinely. Hospice may or may not pay for the medication.
You do not have to be a DNR to be on hospice.
If you have liver cancer you may still see your cardiologist but not your oncologist.
Someone was scared this week that hospice will always stop tube feedings. This is not true. However, at the point at which the patient would have stopped eating (i.e., actively dying) we will suggest that feedings be withheld as it will cause discomfort as the body diverts all resources to breathing and blood flow and digestion and peristalsis cease.