Watching your parents age is difficult for many adult children, especially when the time comes to decide what their future care will look like. But, it’s heartbreaking when that parent has a terminal illness. At some point, you’ll likely have to consider hospice care for them.
How will you know if hospice is the right choice for your aging parent? If your aging parent has been diagnosed with a disease that causes a life expectancy of six months or fewer, then hospice is a good option for them. You can select from end of life care their own home or inpatient hospice services in a hospice facility.
This guide to when hospice care is the right choice for family members will help you make this important decision so you can ensure aging parents get the end of life help they require.
Ahead, we’ll discuss whether a patient can be admitted into a hospice program even if they’re not dying and what the prognosis is once admitted.
What Makes Someone Hospice-Appropriate?
Unlike with assisted living or nursing homes, older adults (or anyone, really) are only eligible for hospice if they meet specific terms. Let’s talk about what makes someone eligible for hospice comfort care.
A Diagnosis Of Six Months To Live
The patient must have been diagnosed by a doctor with a serious illness or medical condition in which they have six months (or fewer) to live without treatment. Diseases such as cancer are one example of when a senior would be eligible for hospice care.
Being Bed Bound
Even if your parent has been given a terminal prognosis, depending on the disease or condition, their decline can either be rapid or more gradual. It’s the rapid declines that make hospice a good decision.
If your senior parent cannot get out of bed, that’s indicative that they’re going to need more advanced care than what they’re currently receiving.
Being bed bound also makes a senior likelier to sleep. The elderly require between seven and eight hours of sleep per night. If your aging parent is sleeping for 10 or 12 hours, or if they’re asleep more often than they’re awake, hospice might be the best option.
Weight loss is often a sign that your elderly parent is no longer caring for their dietary and nutritional needs.
Perhaps they have no appetite due to their disease or the medications they’re taking. They may want to eat but struggle to cook.
In some cases, even if they do eat regularly, they might still lose weight. For example, if your senior parent was diagnosed with cancer, weight loss is more likely to occur.
As a senior’s disease or condition progresses, pain can worsen. The extent and duration of the pain can reduce your aging parent’s quality of life, necessitating pain management.
Since hospice is a palliative care organization, it can be a good idea to talk to your parent’s health care providers to see if it’s the right time to include hospice in their care plan.
Can You Live Alone And Be On Hospice?
While hospice facilities are indeed a viable option for a dying person, they’re not your only choice.
If you’re interested, you can also request in-home support services for a senior parent who lives alone. As that name implies, rather than bringing your senior to a facility where a hospice team can care for them, the team member would visit your senior’s home.
In-home hospice has some benefits over inpatient hospice care (living at a facility). Rather than make your parent adjust to living somewhere new, they can stay in a place that’s familiar and comfortable to them.
This is type of care my mother received from hospice after her terminal diagnosis. For her, it was very comforting to stay in her own surroundings rather than being in a hospital setting.
If your parent has been diagnosed with dementia, however, moving a patient around too often has been proven to worsen the symptoms. We’ve talked about this on the blog recently in several posts. Keeping your senior in one place prevents moving-related dementia declines.
Of course, as the adult child and potential caretaker, you have to think about the costs of inpatient care versus at-home hospice care.
According to hospice center, Auburn Crest Hospice, the daily costs of inpatient hospice care are $500 and home care costs $150 a day.
Doing some math, if a month has 30 days (which is average), then per month, you’d pay $15,000 for your aging parent to receive care at a hospice facility. The in-home costs would be $4,500 per month.
The annual fees of inpatient care would be $180,000, and for in-home hospice care, $54,000.
The good news is that there’s rarely a need for the adult child or family caregivers to pay for this type of care themselves. If the senior parent has Medicare Part A, then this insurance will cover most of the hospice care.
Read more in our article, Does Hospice Take Your Assets?
How Often Do Hospice Aides Visit?
Let’s say you’re leaning towards keeping your aging parent at home so they can receive hospice care where they’re most comfortable. You did some numbers-crunching, and the costs are agreeable with your budget, especially with the Medicare hospice benefit contribution.
One of the perks of an inpatient facility is that the patients can receive care around the clock. If you keep your aging parent at home, how often will the hospice aides visit?
That depends on what kind of medical attention your elderly parent needs. If they’re in relatively good health, all things considered, then the hospice nurse might stop by only a couple of times per week (usually two to three visits per week).
However, if your aging parent is in considerably worse condition, then hospice workers might visit four or five times per week or even every day.
For patients who improve through hospice care, the hospice aides can always reduce their visiting frequency, but they should still come by at least once per week.
Can You Go To Hospice If You Aren’t Dying?
Technically, to be eligible for hospice, a patient must have been diagnosed with a disease or illness and have a prognosis of six months, as we’ve established.
That doesn’t mean the patient is dying right that moment though. Instead, hospice is more about preparing a patient for their final days. It’s a service in which people enroll when they’ve tried medical treatments for their disease or condition and those treatments have been ineffective.
For the time they have left, the older people in hospice care want to focus on being comfortable and enjoying a better quality of life than what they may have right now.
They could die tomorrow, or they could die four months from now, or maybe much later than that. We’ll talk more about that momentarily.
For now though, the senior knows they’re receiving excellent care and additional support during a difficult time, whether at home or at a hospice facility.
How Long Do The Elderly Live In Hospice?
Let’s go back to what we said about hospice eligibility just this one last time. The patient has received a prognosis from their doctor that they’ll live for six months.
However, a prognosis for terminal illnesses is nothing more than a medical prediction. Most of the time, the doctors making prognoses are accurate, but not exclusively. Being sent to hospice care or receiving it at home is not a six-month death sentence for seniors.
As we touched on, seniors can live even longer in hospice care. That depends on how quickly their disease or condition takes hold and the level of medical care they’re receiving.
A 2014 report in the Journal of Palliative Medicine reviewed 126,620 hospice patients across 10 hospice facilities. Of the 126,620 patients admitted, within six months, 118,532 of them passed away.
That leaves another 8,088 that lived longer than six months.
Here’s what the Journal reported: “Although most patients die very soon after hospice enrollment, there is a small minority of patients who have an extended survival. These patients may live 6 months or more, and creates pressures for hospices to prepare parents and families for potential discharge if they no longer meet the eligibility criteria.”
That is indeed a good point. For those patients who become better through hospice care, you, a primary caregiver, or the senior themselves can revoke hospice. We’ve discussed this on the blog before.
Revoking hospice doesn’t happen often, but it’s a possibility nevertheless, so it’s good to have it tucked into the back of your mind just in case.
If your aging parent has been diagnosed by a doctor with a condition or disease that leaves them with six months or less to live, then they’re eligible for hospice care. Hospice can occur at an inpatient facility or in a patient’s home with visiting hospice aides.
Most patients who enter hospice will die within six months, just as their doctor projected. That gives the impression that hospice is a death sentence. It’s more like a place of comfort so the senior can spend their last days restfully.
We hope this article helps you decide whether hospice is the right choice for your senior parent!