Cons of Hospice Care

Hospice is a philosophy of care that strives to provide comfort and support to people who are terminally ill with six or less months to live. They can go to an inpatient hospice facility or stay in their own homes. Either way, a team of health care professionals work together to make the dying process as peaceful as humanly possible. One goal is alleviation of pain. Bereavement counseling is available for families before and after their loved one has passed away. There are drawbacks to hospice which patients and families must consider before deciding if it is right for them.

Families Must Acknowledge that Death is Imminent

• It is difficult for families to accept that their loved one is dying. The patient's illness may be unresponsive to treatment, he may have refused treatment, or there may not be any treatment options left. Families may believe that the physician has given up hope and abandoned their loved one. They may even demand a second opinion elsewhere. Anger and frustration are common emotions when families are not ready to let go. They may not be able to accept that their loved one is not going to get better.

Hospice Does Not Provide 24 Hour Care at Home

• If patients choose to spend their last days at home, hospice does not provide around-the-clock care. A case manager, who is a registered nurse, routinely checks on the patient, and a home health aide may come several times a week to assist with bathing or other activities. An on-call nurse is a phone call away if the family needs immediate assistance. The imposition of caring for the patient usually falls on a family member such as the spouse, who may need to go part-time at work or quit her job altogether. Familial income drops. Exhaustion and burnout are common among caregivers of terminally ill patients. Some families may opt to hire a caregiver instead of having one member assume the role.

Hospice Philosophy Emphasizes Comfort, Not Cures

• Private insurance, Medicare, and Medicaid pays for medication and services that enable a patient to achieve a peaceful end. Therefore, there are usually limitations to services that are deemed to prolong life. Most hospice patients do not have intravenous lines or feeding tubes in place. It may be difficult to receive chest x-rays or have blood work done, even if it is ordered by the physician, because the results will not change how the individual's care is currently being managed. Patients are prohibited from enrolling in clinical trials. Hospitalization is rare, but third-party payers allow temporary hospitalization of patients who need symptom management.