When curative therapies are considered futile or the burden of treatment exceeds the advantages, hospice care has a great deal to offer. Philadelphia patients receive the support they need to manage their symptoms at home, and services benefit their loved ones, too, ensuring they have the resources to cope.
But is a referral from a physician required for hospice care?
Yes and no. While services cannot begin until a doctor certifies that a patient is eligible, there is no need to wait for a physician to raise the possibility of hospice care. Anyone can make the initial call to a Philadelphia hospice agency, as the staff can facilitate the referral process. Keep reading to learn more.
The Right Time for Hospice Care
Many doctors may overestimate the life expectancy of their patients. Even oncologists, palliative care physicians and medical specialists who routinely care for incurably ill individuals find it difficult to accurately predict survival time.
Research through the University of Chicago Medical Center illustrates this point. In the study, 343 physicians were asked to estimate the prognosis of 468 terminally ill patients at the time of hospice care referral. Only 20 percent came close to the mark – and 63 percent of the predictions were overly optimistic.
Why does this matter?
Medicare, Medicaid and most private insurance plans cover hospice care for individuals with a medical prognosis of six months or less, assuming their disease runs the normal course. Patients are eligible to receive services for two benefit periods, each lasting 90 days. After that, those who continue to meet the criteria can continue to receive the care they need for an unlimited number of 60-day periods.
Time in hospice care doesn’t have to be short, but that’s the reality for many patients. According to a report from the National Hospice and Palliative Care Organization (NHPCO), 75 percent of those enrolled received services for 87 days or less – and half were only in hospice for no more than 18 days.
Clearly, most people aren’t fully benefiting from the services available. As doctors have trouble accurately predicting the right time for hospice care, others might need to step in and make the call.
Who Can Make a Hospice Referral?
As the end of life draws near, doctors do initiate hospice referrals. But like we said above, anyone can refer a patient – and in many cases, a physician isn’t the person suggesting hospice care. Quite often, the referring individuals fall into one of the following categories:
Other Professionals
Along with doctors, others who work in health care also refer patients to hospice when they see the need or believe services would be beneficial. For instance, nurses and home health aides may recognize signs of deterioration in a patient before a physician.
Sometimes, the person suggesting hospice care is a professional in a different field. Social workers, clergy members, patient advocates, housekeepers and residential facility staff are among those who make hospice referrals.
Friends and Family
People who are close to a terminally ill individual are frequently the first to notice symptoms of decline. At that point, they can make a referral for hospice services – however, everyone involved, including the patient, should have a conversation.
Friends and family members have the best intentions, but a hospice referral for a loved one should only be made with their consent. If the patient says no, sharing information may be helpful. Upon learning about the benefits, their decision may change.
When to Consider a Hospice Referral
If a loved one has a terminal illness, discussing the option of hospice care early on – before services are needed – can be beneficial. Having everyone on the same page should help with the decision-making at the final stages.
As for when to make a hospice referral, that depends on when your loved one starts to decline in health. If any of the following is true, it may be time to make the call:
- Emergency room visits and hospitalizations are more frequent
- Pain flare-ups are increasing or other symptoms are worsening
- More and more time is spent sleeping throughout the day
- Fatigue and weakness are making self-care tasks more difficult
- Unintentional weight loss or a lack of interest in eating is a concern
- Episodes of confusion, restlessness or disorientation are common
Other end-of-life signs to watch for include shortness of breath when resting, the loss of urinary or bowel control, a lack of interest in usual activities and withdrawal from family and friends. In any event, if you notice anything that leads you to believe that now is the right time for hospice care for your loved one, you may want to pick up the phone.
At Suncrest, a leading Philadelphia hospice agency, we’re always ready to take your call. You don’t need a physician referral to get more information about our services, and if it appears that hospice care would be beneficial for your loved one, we can contact their doctor to discuss the matter.
To learn about Suncrest or to make a hospice referral, contact our office in Philadelphia, Pennsylvania, today.
