Patient Referral

Why Do Healthcare Professionals Wait So Long To Recommend Hospice

Death may be inevitable, but it’s still a taboo topic for most people – including healthcare professionals. This is why healthcare professionals wait so long to recommend hospice despite studies that show discussing end-of-life wishes with their patients improves patient quality of life, reduces family caregiver burden, and strengthens the relationship between the healthcare professional and their patient. Yet, many healthcare professionals remain hesitant.  

Why healthcare professionals avoid end-of-life conversations.

One reason healthcare professionals wait so long to recommend hospice is that they believe you shouldn’t talk about hospice until it is absolutely necessary. Some believe the conversion should be initiated by the patient or family. Some wait until the patient is hospitalized. Others wait until they believe they’ve exhausted all their treatment options. While well intentioned, this delay can lead to increased pain and caregiving challenges as families are unaware that other options are available to them. 

Another reason healthcare professionals are reluctant to begin end-of-life conversations is the fear that this will be perceived as “giving up on their patient” or lead to reduction in patient hope. Yet when clinicians do have these conversations early, patients report feeling empowered with the ability to influence their care which reduces their anxiety.  

Finally, healthcare professionals often confess that they find themselves too busy to make time for a proper conversation about their patient’s goals of care. However, when healthcare professionals begin having even a short conversation about end-of-life wishes early in patient care, it builds trust and makes difficult decisions easier for the patient and their families down the road.  

Despite having the best of intentions, skipping these conversations means many healthcare workers are missing the opportunity to focus on what matters most to their patient. 

Refocusing the conversation on what matters most.

Instead of waiting until there is a crisis, healthcare professionals can start the conversation about the patient’s goals early in treatment.  

Important questions to ask are: 

  • How much do you want to know about your condition? Just the basics? Every detail? Something in between? 
  • What do you value most about your life? 
  • Do you want to get treatment indefinitely, regardless of how uncomfortable it gets, or is quality of life more important to you? 
  • Do you understand how treatment side effects may affect you? 
  • When the time comes, do you want to spend your last days at home? Or are you okay being in a hospital or nursing facility? 

Healthcare professionals should reassure their patient that these questions are not being asked because of their current health or treatment decisions, but rather because it’s important to know this information for the future so the best care can be provided should a time of crisis arise.  

These should not be one-time-only conversations, but rather a serious of conversations over the course of treating the patient. This gets the patient thinking about their preferences and goals and helps their healthcare practitioner best meet their needs over time. 

These conversations can be difficult, but Crossroads Hospice & Palliative Care is here to help. We are available 24 hours a day, 7 days a week, 365 days a year to answer your questions about hospice care, admit patients, and provide care.