To qualify for hospice care, a patient must have a life expectancy of six months or less. But the exact date of death is impossible to predict.
When a doctor tells a patient that he may live for another month or maybe another six months, the doctor is saying, “Your condition is terminal, but I don’t know exactly how long you have.” When a patient is given a terminal diagnosis, an oncologist (or other specialist) may not be fully aware of other factors that can move a patient closer to or farther from death.
Is there a history of smoking, excessive drinking, drug use, diabetes, pneumonia, mental illness, obesity or other conditions? The answers can help a doctor offer a more accurate educated guess regarding the remaining time for the patient, but there can be no precise determination. Even patients on death’s doorstep, for whom bedside death watches are undertaken by family, often live for several days or even weeks before passing.
Can a patient go on hospice too early? Yes. When a patient is on hospice care and does not pass away within six months, the patient must be recertified. If the patient is found to have improved and, if the determination is made that death is no longer expected in six months, the patient goes off the hospice patient roster. But, if the patient’s reevaluation reveals that she or he still has a life expectancy of six months or less, the patient can continue to receive hospice care.
Can a patient go on hospice too late? Yes. Patients and families often have the incorrect idea that hospice care is only for the final days of life. In many situations, the patient or family does not completely understand the full scope of hospice care. This is why we constantly work to tell people the hospice story.
We have witnessed patients whose time with us exceeded expectations. We have also had patients who passed suddenly, much quicker than anticipated. The “six months or less” life expectancy is an estimate. No one can predict exactly.
(For information about hospice care, call Hope Hospice at 314-984-9800.)