Many physicians are reluctant to recommend hospice. It is sad and confusing why they would not give their patients the guidance and comfort that trained hospice professionals can offer. Maybe this reluctance to refer has to do with seeing death as a failure, maybe it is just ignorance as to the true value of hospice. It is perfectly acceptable to ask a physician for a hospice referral. If the signs are there, get the referral and let a hospice professional determine if Hospice is appropriate. Three things I look for to tell me if it is time for Hospice are: 1. the patient’s condition is deteriorating in spite of the treatment that is being given. 2. You look at the person and say to yourself (and we have all done this but often not wanted to admit it) this person is not going to be here next year at this time. 3. the family and/or significant others are having difficulty coping with the seriousness of their loved one’s condition.

We generally give people more time then they have. I know it is scary to think of using hospice. It says death will happen soon, but there is such guidance and support to help that at least ask for an information visit. A hospice referral is a win win. You win if they say it is too soon and you are not appropriate for hospice care or you win by coming onto the hospice program and getting much needed guidance, information and support.

Sometimes patients rally once they are with hospice care. I think it is because hospice is the expert in pain management and comfort care and brings that to the patient and family. Everybody begins to relax a little. You feel less alone, less isolated and have more knowledge about what happens as death approaches.

I know people think of Hospice as caring for those people that are dying but remember we are all dying. Hospice guides and supports people who are in the final act of living.