Weekly Tips & Insights

Three Things to Consider for End-of-Life Care

Though conversations around end-of-life care are never easy, there are some things you can do to ease the burden and make sure everyone’s wishes, the patient’s especially, are considered. Here are three things to consider when making decisions around end-of-life care.


Talking to primary care physicians (PCPs)


Oftentimes, PCPs can be uncomfortable discussing end of life issues, so when you initiate the conversation and let the physician know that you are seeing a decline, it can help open the door to that talk. Here are some questions to break the ice:


  • How long does my loved one have to live?

  • How can we best honor their wishes for the end of life?

  • How do we keep them comfortable?

  • What medications are available?


Getting involved in your loved one’s care plan


Patients and their caregivers should be involved in the development of the care plan. This is a tool used by hospice providers to guide the care of patients. It includes things like keeping the skin without bedsores, proper nutrition, pain management, sleeping patterns, symptom management and bowel routine. To make sure patient and caregiver wishes are followed, be vocal about your preferences when developing a plan with a hospice provider and PCP.


Selecting a hospice care provider


There are plenty of hospice care providers out there, some large and some small. Some nonprofit, some for-profit. Finding the right care provider is about finding the best fit for the patient and family needs.


Small hospices tend to have less staff changes, and one nurse handles 10 to 15 patients. There is also one physician for all the patients, so medical care is more personalized. Larger hospices may have more amenities and offer more specialized therapies, but the staff will be more transient and patients may have rotating physicians. Nurses also carry a larger load and have fewer minutes to spend with each patient.


The cost of hospice is covered by Medicare regardless of a provider’s profit status, and all hospice providers follow the same Medicare guidelines. When deciding between a nonprofit and for-profit hospice provider, pay close attention to their mission and how their money is being allocated, and that can help inform your decision.



Remember, there are often no correct answers when it comes to end-of-life care. What’s most important is that the patient’s wishes are honored, and that means talking to doctors, being involved in developing care plans and knowing what type of hospice provider best fits you and your loved one’s preferences.


Looking for more information on hospice care? Here are some other helpful stories VNA has written:


https://www.vnastl.com/post/hospice-billing-faqs

https://www.vnastl.com/post/how-to-talk-to-family-and-loved-ones-about-end-of-life-care

https://www.vnastl.com/post/5-questions-caregivers-ask-about-hospice-safety-and-covid-19

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