The Physician’s Role The decision to enroll in hospice services can be difficult for patients and families, and may reflect a reluctance to accept a terminal diagnosis. The physician pays a central role in helping patients and families make the switch from life-prolonging treatment, when it is no longer appropriate, to an approach focused on end-of-life care goals. Patients need assurance that no matter what treatment option is chosen, the goal of comfort will always be paramount. The topic of “care goals” should be introduced early in the disease course so these goals can be defined well before a crisis occurs.
Physicians have expressed their concerns to me regarding having end-of-life discussions with their terminally ill patients. Many fear they will destroy hope if they talk about death. But in interviews with 100 family members of 100 patients who died while under hospice services conducted by the Leonard Davis Institute of Health Economics, families expressed “excellent” ratings of satisfaction with care.1 The findings include: Only half of family members reported that the physician initiated the discussion of hospice, and often it was the patient who did.
Only 22 stated that their physician provided information about hospice, with most of the information coming from hospice representatives.
Most recalled at least one event that precipitated the hospice discussion, including escalating needs for home care, whether to initiate, withdraw...Click here to read more from Gilbert Guide