According to Erin Wolfe, Information and Referral Specialist at SUN Home Health Services, Inc., the answer is not likely.

“Frequently, referrals to hospice come late in a patient’s disease process. The optimum period for the hospice team to be able to improve the quality of a patient’s end of life is 90 days. If a patient is admitted very late in the disease process, hospice may have the patient and family only a few days before death. In those cases, the patient is not likely to receive the full benefit of end of life care, the kind of care the nurses at SUN Home Health are trained to give,” Wolfe said.

Maggie Henderson, SUN Home Hospice Program Manager, notes that it is of benefit to refer a patient to hospice when:

1. The physician believes a patient has a prognosis of 6 months or less.

2. Aggressive treatments are no longer providing the desired result.

3. The physician feels the patient and family would benefit from the emotional, physical, and financial supports that hospice can provide recognizing that the care is palliative in nature.

So, when is Hospice care right for your patient?

• When the family’s and patient’s needs are such that they require many extra hours from you and your staff for patient case management – Staff at SUN Home Health Services are on call 24-hours a day, 365 days a year, providing patient and family care, and can be your link to the family and patient in these trying times.
• When more physical and emotional care is needed than office visits will allow – Hospice care is never a replacement for the physician, but an extension of the physician’s services.
• When the family is in need of support – The Hospice supportive care network includes a team of aides, social workers, a chaplain, nurses and volunteers, all involved in a patient’s plan of care.

There are some stipulations for receiving Hospice care. A physician must certify that a patient has a life-limiting illness and has a life expectancy of six months or less. These certifications require only the physicians best professional judgment or assessment. There are procedures allowing for additional certifications should the patient continue past the initial six-month period. Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient’s physical condition. They need not be “bedridden” or in the final days of life.

“If a patient improves while under the care of SUN Home Hospice, he or she can be discharged to return to more aggressive treatment, or even resume activities of daily life,” Wolfe said.

“It is important to note that Hospice is a philosophy of care – focused on pain management issues and providing clinical and emotional support for patients and their families,” according to Henderson. “Care provided in the home allows families to be together when they need it most, sharing a loved one’s final days in peace, comfort and dignity. SUN Home Hospice is not just for cancer patients. While many of our patients have conditions related to cancer, there are other frequent admitting diagnoses. Those include: diseases of the circulatory system; infectious and parasitic diseases, which include HIV; diseases of the nervous system and sensory organs, including Alzheimer’s, Parkinson’s, and meningitis; and diseases of the respiratory system.”

Although insurance coverage for Hospice is available through Medicare and Medicaid, most private insurance plans, HMOs and other managed care organizations include hospice care as a benefit. In addition, through community contributions, memorial donations and foundation gifts, many hospices are able to provide patients who lack sufficient payment with services. SUN Home Health provided more than $200,000 in charity care in 2003.

Hospice reinforces the patient-primary physician relationship by advocating either office or home visits during hospice care, planned according to the physician preference. Hospice works closely with the primary physician and considers the continuation of the patient-physician relationship to be of the highest priority.

Together, the patient, family and physician can determine when Hospice services should begin.

To make a referral, call 1-888-478-6227.