Q: The family of one of my resident’s wants the resident to be placed on comfort measures instead of Hospice even though Hospice would be appropriate right now. The family and the doctor are willing to sign a release to do this. Do you think it is OK? What about licensing?
A: First of all we always recommend Hospice when it is appropriate. Remember Hospice is not just for the resident. It is also for the family and for the caregivers. There is also the benefit of counseling for those grieving during the first year after the Hospice patient dies.
You cannot force the resident to go on Hospice. However, without the resident entering into a Hospice program they may quickly move to a level beyond the scope of residential care. The resident could ultimately end up in a skilled nursing facility to live out their days. It is important to have a straight forward discussion with family members about Hospice and educate them on the it's benefits.
The Hospice regulations can be found in Title 22 on page 172
section 87633 (HOSPICE CARE FOR TERMINALLY ILL RESIDENTS)
Remember that when the resident becomes total care you still need to send in for a Total Care exception. This should change with licensing in the near future when it will be part of the Hospice Waiver.
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