The main qualification for admitting a new patient to hospice care is a diagnosis stating that the patient has six months or less to live. But that diagnosis is an educated guess. In many instances, such a diagnosis is amazingly accurate—but not always.
Sometimes this speculation significantly underestimates a patient’s remaining months of life. Many hospice patients live beyond six months. A variety of factors can affect a patient’s longevity.
Occasionally, removing a patient from aggressive drug treatment can have positive results when major side effects are taken away. The tests and observations that identified the reason for the six-months-or-less estimate are not necessarily rendered invalid. But a change in circumstances can lead to other physical changes and attitude changes.
With certain illnesses and diseases, life expectancy can be predicted more accurately, based on medical records of other patients. But with other conditions, data may be more difficult to analyze, making the time until a patient’s passing harder to pinpoint.
Additionally, patients often strive to hang on for milestone events: Christmas, Easter, an anniversary or other family event. This determination to stay alive can actually help extend life. We at Hope Hospice have seen it occur many times. Often, once the milestone has been celebrated, a patient’s decline can be rapid.
Just because a patient is admitted to hospice care, friends and family should not presume that her or his demise is imminent. Yes, in some cases when family or caregivers wait until the very last days of life, death comes quickly. But when a doctor tells a patient that he or she should go on hospice care, this means that end-of-life is approaching. It does not mean that it is just around the next bend.
Sometimes patients do stay on hospice care beyond six months. They must be periodically re-certified according to state guidelines. At Hope Hospice, in the majority of situations, the conditions of our longer-term patients generally dictate that continued hospice care is the most appropriate form of healthcare for them.
As pointed out above, determining how long a patient will live is an inexact science. Doctors and other medical professionals give us their best evaluations and we do our best to make each patient’s end-of-life experience as comfortable and pain-free as possible.