In January 2026, Mike Salmon, aged 73, faced life-threatening health issues including aortic aneurysms, sepsis, and a period of delirium. After enduring several operations, doctors recommended further surgeries. However, the prognosis was grim without intervention. Mike opted for hospice care instead of pursuing risky procedures.
Hospice care aims to manage comfort for terminally ill patients without offering curative treatments. Over 1.9 million Americans were enrolled in hospice care last fiscal year, but 6% were discharged due to stabilization or improvement. Mike’s experience revealed valuable lessons in choosing and utilizing hospice services.
Choosing the Right Hospice
Faced with immediate decisions, Mike’s family selected a hospice agency from a list provided by a nurse. This led to initial service issues due to inadequate agency quality. Amy Tucci from the Hospice Foundation of America emphasizes checking ratings on Medicare’s Care Compare and the National Hospice Locator. Kristina Newport suggests selecting an agency that provides necessary services, such as language and spiritual care.
Health Improvements in Hospice
While unexpected, some patients improve in hospice care. Research indicates certain patients like those with heart failure or lung cancer may live longer compared to traditional medical settings. Factors include effective pain management and reduced risk of infection from hospital environments. Mike benefitted from personalized care, improved nourishment, and better sleep at home.
Facing Discharge from Hospice
Hospice services are typically covered for patients with a prognosis of six months or less. Agencies face pressures related to Medicare audits, which sometimes leads to discharges when patients improve. Krista Harrison from UCSF highlights the challenges families face when adjusting quickly to losing hospice support without adequate preparation.
Ensuring Continual Hospice Care
- Understand the risk of discharge for certain conditions such as dementia or heart disease.
- Choose highly rated, preferably nonprofit, hospice agencies using resources like Medicare’s Care Compare.
- Document care needs to advocate for continued hospice support.
- Involve your primary doctor for a broader perspective on medical decisions.
- Prepare to appeal quickly if facing hospice discharge, as deadlines are short.
If discharged, reenrollment in hospice can be pursued either immediately with a new agency or later if health declines. Mike and his family plan to reenroll with the original agency when necessary, assured of receiving quality hospice care when needed.
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