When a person is suffering with heart disease, when it is time to call hospice?
Hospice doesn't shorten or prolong life. Instead, it focuses on comfort, not on curing an illness. Hospice is meant for people who have less than six months to live, but with heart disease, it can be difficult to know when that time arrives to call hospice.
According to Vitas, the nation's largest provider of hospice care, heart disease patients are considered in the end stages of heart disease and will be eligible for hospice if they:
- Have advanced congestive heart failure or advanced coronary disease with frequent episodes of angina while at rest (chest pain resulting from insufficient supply of blood and oxygen to the heart)
- Patient is already optimally treated with diuretics and vasodilators, which may include Angiotensin-converting enzyme (ACE) inhibitors or the combination of hydralazine and nitrates. If side effects, such as hypotension or hyperkalemia, prohibit the use of ACE inhibitors or the combination of hydralazine and nitrates, this must be documented in the medical records.
- Have an abnormal heart due to disease and suffers from significant symptoms of fatigue, shortness of breath or functional decline
- Have already received optimal treatment for their disease and are not candidates for further surgical or medical interventions
- Have already received treatment for their disease and have chosen not to pursue advanced specialized treatment.
- Documentation of ejection fraction of 20% or less (only if available)
Hospice care is provided by a specially trained team that cares for the "whole person," including his or her physical, emotional, social, and spiritual needs.
Hospice services may include drugs, physical care, counseling, equipment, and supplies for the terminal illness. Hospice staff is on-call 24 hours a day, seven days a week and focuses on supportive care and pain relief.
Services that Hospice Provides
Hospice care includes the following services, according to Vitas, a provider of end of life care.
- A Hospice Care team
An "interdisciplinary health care team" manages hospice care. This means that many people work together to care for the patient. Doctors specializing in cancer care, nurses, social workers, hospice aids, clergy and bereavement specialists.
- Pain and Symptom Control
The goal is to help the person with cancer be as comfortable as possible and free of pain.
- Emotional and Spiritual Care
Hospice care helps with emotional well-being and tends to spiritual needs, based on the person's religious beliefs.
- Grieving and Bereavement Counseling
Bereavement is the time of mourning that occurs after the person with cancer dies. The hospice care team works with surviving loved ones to help them through the grieving process.
- Coordinating Care for the Person with Heart Disease
The interdisciplinary team coordinates and supervises all care 7 days a week, 24 hours a day. This team is responsible for making sure that everyone involved in the cancer patient's care shares information and communicate.
Hospice can provided at home where the person with heart disease lives, or in a residential facility such as assisted living, nursing home or an in-patient hospice care center.