This article is a continuation of our series on heart failure and hospice care. In the previous articles, we provided an overview of benefits and barriers for patients with life-limiting heart disease and hospice/palliative care providers. See the previous articles:
- Life-Limiting Heart Disease and Hospice Care – Part 1
- Life-Limiting Heart Disease and Hospice Care – Part 2
In Part 1, we covered the disease factors that introduce barriers to receiving hospice and palliative care for patients with heart disease. The progression and prognosis of heart disease creates several barriers to providing a referral to hospice and palliative care. In Part 2, we covered the policy factors that impede access to hospice care. The insurance requirements, payment rate, and lack of concurrent care options provide a significant barrier to care.
Is Hospice the Answer
The frequency of emergency care is the number one indicator of life-limiting heart disease. Patients who have been hospitalized or gone to the ER several times in the last 6 months should be considered for referral to hospice or palliative care. Also, a marked increase in physician contact is considered a precursor to increased hospitalizations. The use of medication to lessen physical pain is an indication of the need for care provided by hospice and palliative services.
Reduced patient mobility is a major contribution to reduced quality of life for patients with heart disease. Patients who have become more sedentary by spending most of the day in a chair or bed, who have fallen several times in the past 6 months, or who have needed more help with daily grooming activities are candidates for hospice and palliative care.
Lastly, patients with indications of general lack of ability to care for themselves should be evaluated for hospice. Indicators include increased tiredness, loss of strength, weight loss, and shortness of breath even while resting. Taken together, patients with a diagnosis of heart failure who have an increased need for care, reduced mobility, and general inability to care for themselves are prospects for hospice and palliative care. A hospice referral for these patients can result in better outcomes for the patient and family.
Download the questionnaire to see if hospice care is right for your loved one. Additional guidelines based on other disease states can be found in our resources.