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Adil Mohyuddin, M.D., a cancer specialist in Tullahoma, Tennessee, knew all the fine points about hospice care. His patients trusted him to guide them through the flood of emotional decisions that come with a life-limiting illness. Even as a doctor with extensive experience, he struggled with the timing of end-of-life 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. He was more like himself. Although he passed away before getting in the drug trial, he didn’t have the pain and stress that came before getting the pump.”
Decisions surrounding the timing of end-of-life care can be difficult—for families and doctors. Care tends to focus on treatments. Too often, decisions are pushed down the road until a patient loses the ability to share what matters most to them and how they want to live.
Patients often say quality of life is more important than how long they’ll live. Clear conversations with patients and family members are key to honoring a patient's goals and priorities. An ideal tool for sharing goals and expectations about end-of-life is through advance directive documents.
Hospice care is not about deciding how to die, it's about deciding how to live life with the time that's left. It's the part about how much time is left that creates much of the confusion and doubt. No one wants hospice too early.
Medical requirements state that a patient is hospice eligible when a doctor certifies the patient is terminally ill and death is expected in six months or less. The patient or the family must be aware of the prognosis and decide on comfort care rather than curative treatment for the terminal condition.
Some people choose hospice care when they want intensive relief of symptoms so they can focus on time with loved ones or being at home. It's a decision to seek comfort over cure.
Hospice is also not a permanent choice. Patients can end care for any reason and return to curative treatments.
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.