If you have severe heart disease and are considering hospice care, you’ve likely been through a grueling cycle of worsening symptoms, multiple doctor visits and hospital stays, followed by a slight improvement of symptoms for a time, only to have the cycle repeat itself. How do you know when to stop the cycle and start hospice care?
When considering hospice care, two questions have to be answered:
- Would I qualify for hospice care?
- What are my personal goals for my care?
Would I Qualify for Hospice?
To qualify for hospice care with heart disease, you would have to meet certain criteria and two doctors would need to say you have a reasonable life expectancy of six months or less. Hospice may be a good choice for you if you have been seen by a board-certified cardiologist and have been told that there is nothing more that can be done to improve your heart function or prolong your life.
If you have any doubt about your prognosis, consult with another board-certified cardiologist. Sometimes patients are referred to hospice before every aggressive treatment has been tried. It’s important to feel like you have received every possible treatment to manage your disease before considering comfort care.
What are My Goals of Care?
Hospice would be very appropriate for someone who meets the hospice criteria AND:
- wants to be treated at home and avoid hospital admissions,
- wants to focus on treating their symptoms rather than on curing their illness and
- welcomes the help of the hospice team to help with accessing community resources and assisting with emotional and spiritual needs
If you are still unsure about whether you would want to call the paramedics or otherwise be taken to the hospital with severe symptoms, hospice may not be right for you. Medicare and most private insurance plans won’t cover hospice services and hospital admissions for the same diagnosis at the same time. That means that if you are on hospice for heart disease and you start experiencing chest pain or shortness of breath, a hospital visit would most likely not be paid for.
This doesn’t mean you won’t receive care, however. If you were under hospice care and had these symptoms, you would likely already have medications on hand to treat the symptoms and the hospice agency would send a nurse to see you and help you get comfortable again.
If you still have doubts about whether hospice is right for you, talk it over with your doctor. You can also request a hospice evaluation for no charge. Your local hospice agency will send you a representative who can discuss your goals of care and what hospice can offer you.
