Adil Mohyuddin, M.D., a cancer specialist in Tullahoma, Tennessee, knew all the fine points about hospice care. His patients often trusted him to guide them through the flood of emotional decisions that come with a life-limiting illness. Even as a doctor with extensive hospice experience, he and his family struggled with the timing of hospice care during his own cancer diagnosis.
“Adil was trying to enroll in one last chemotherapy drug trial,” said his wife Sabina. “He was in pain and didn't think hospice was an option while waiting on the drug trial. When he finally chose hospice and got a pain pump, his mind and body had time to rest and he was more like himself. Although he passed away before getting in the drug trial, he didn’t have the stress that would often come with spikes in his pain.”
Decisions surrounding the timing of end-of-life care can be difficult—for families and doctors. Care tends to focus on treatments. Too often, hospice or palliative care decisions are pushed down the road until patients lose the ability to share what matters most to them and how they want to live their final chapters of life.
If someone is having increasing difficulty with basic tasks such as walking, getting up from a chair, bathing, dressing or using the toilet, you may want to consider hospice. Signals that it may be time to consider hospice include:
- Frequent hospitalizations or trips to the ER
- Frequent or reoccurring infections
- Reduced desire to eat, leading to significant weight loss
- Inability to perform tasks of daily living, such as eating, walking, using the bathroom, personal cleaning or getting dressed
- Rapid decline in health over past six months, even with aggressive medical treatments
- Uncontrolled pain, shortness of breath, nausea or vomiting
- Decreasing alertness, withdrawal or mental confusion
- Decision to focus on quality of life, instead of aggressive treatments.
Patients often say quality of life is more important than how long they’ll live. When someone begins to ask patients about their goals and priorities, those patients are less likely to receive medical treatment they don't want. An ideal tool for sharing end-of-life goals is through advance directive documents.
Hospice is a fully covered Medicare benefit
Coverage includes nurses, other caregivers, medicines, supplies, equipment and support, with no out-of-pocket expenses for the hospice diagnosis.