Dear Barbara, as a hospice admission representative, what do I say to families who say they are “not ready” for hospice — even when they clearly are?

There is an old saying "you can lead a horse to water but you can't make him drink." I think that applies here. Our job is to explain hospice benefits and requirements, to explain that dying has a process, and that hospice can help during this challenging time. 

Part of "selling" hospice is to create trust and a bond during that first meeting. It takes people skills in addition to knowledge of hospice benefits.  

Bottom line is: provide the best, do the best education of hospice, its services, and a bit of what to expect as end of life approaches. You want them to know how hospice can support, guide, and be of service during that time.

BUT there will be times when all the above is done and the person or family choose not to come on service. Then — they won't come on service. You tell them that if they change their mind, you would welcome a phone call and you will begin services.

I don’t mean to plug my booklets (well, yes, I do) but leave with them Gone From My Sight. It will give them guidance. Probably, when they see their special person in the pages, they will indeed call for hospice to begin.  

Remember when people call for a hospice referral, they generally needed its services weeks before they got the courage to call. When people are referred to hospice by an outsider, such as a physician or palliative care team, they are generally not ready to hear or see that the end of life is indeed approaching. Patience, understanding, and education — all with gentleness — are the tools we bring to a hospice information visit.

Something more… about When Families Resist Calling In Hospice