Research through the National Hospice and Palliative Care Organization (NHPCO) has shown that many terminally ill individuals who choose hospice care live longer than those who don’t – 29 days longer, on average. And here at Suncrest Hospice of Tulsa, we’ve seen several patients enjoy an unexpectedly long period of time on hospice. A small minority even surpass the six-month mark.
So, what happens when someone in hospice care survives for longer than six months?
Many people worry that services will be automatically discontinued, but that isn’t necessarily the case. Although a prognosis of six months or less is a requirement to receive hospice care, Tulsa patients aren’t penalized for living longer. Read on to learn more.
The Six-Month Prognosis for Hospice Care
To qualify for hospice care, a patient must be both terminally ill – meaning that they have a condition that can’t be cured – and expected to live for six months or less, assuming their illness takes the usual course. Before that point, services won’t be covered by Medicare, the Oklahoma Medicaid program or private health insurance.
That being said, the six-month prognosis is really more of a guideline than a definitive timeline. Doctors don’t find it easy to predict how long a terminally ill individual will live, as everyone’s situation is unique. During the final months and weeks, diseases can take different paths, and occasionally, a patient’s health improves after entering hospice care.
How can that happen?
According to the NHPCO, hospice patients are likely to:
- Avoid the potential problems and harmful side effects that can come with overtreatment
- Benefit from additional monitoring and palliative therapies only available in hospice care
- Develop a strong desire to live due to the care taken with physical and emotional well-being
Improvements in health after entering hospice are generally considered to be connected to improvements in care. It may be because of the medication adjustments, nutritional guidance or spiritual and social support – or it could be a combination of factors – but in any case, patients do sometimes outlive their initial prognosis. So while a life expectancy of six months or less is required to initiate hospice care, there isn’t a six-month limit on hospice services.
Providing Hospice Services Past the Six-Month Point
For a terminally ill individual to enter hospice, a physician must certify that their death is likely to occur within six months. If they survive for longer, they face one of two scenarios.
First, if a doctor believes that the individual still has a limited life expectancy, services can continue unabated. Medicare, Medicaid and most private insurers cover hospice care in benefit periods – two 90-day periods followed by an unlimited number of 60-day periods. Doctors assess the situation near the end of each period, and as long as the prognosis hasn’t changed, the patient remains eligible for hospice care.
Secondly, if a doctor attests that a patient no longer has a terminal diagnosis or limited life expectancy, hospice coverage comes to a stop. The individual is discharged, and they may transition to palliative or home health care. Later on, if their health begins to decline and it’s believed that they won’t live for longer than six months, they can resume hospice care.
Adapting the Hospice Plan of Care as Needs Change
In hospice care, providing support at every stage of the end-of-life journey is the priority. Patients have a team of skilled professionals assisting with their care, and as their physical, emotional, spiritual and social needs are met, they’re able to enjoy the best possible quality of life.
However, during their time in hospice, patients often come to have previously unencountered problems. As a terminal illness progresses, new symptoms may appear and additional help may be required. The wishes and goals of the patient may change, too, so the plan of care is never set in stone. Hospice professionals aim to ensure comfort and well-being at every stage by:
- Customizing the plan of care to align with the unique requirements and preferences of the patient
- Keeping a close eye on the patient’s condition and adapting the care plan to meet their ever-evolving needs
- Joining forces with the patient and their family to provide the right hospice services at the right time
The plan of care is reassessed as frequently as necessary, given the patient’s condition. But whatever the situation, the hospice team reviews the care plan a minimum of once every 15 days. By doing so, they can coordinate services and arrange for support that allows for a comfortable and peaceful end-of-life experience.
At Suncrest Hospice of Tulsa, our dedicated team offers comprehensive and compassionate care to individuals with terminal illnesses. And when a patient happens to live longer than six months, we see it is a testament to their strength and resilience – and we celebrate the gift of extra time. For more information on our services, or to discuss hospice care for a loved one in Tulsa, Oklahoma, contact us today.
