Many physicians and care professionals may be reluctant to refer to hospice because they do not want the patient to lose hope or don't believe the patient is "ready" to accept death is approaching.
Compassionately telling your patient and their family that death is becoming near is a gift. It allows the patient and family time to focus on what's important and to address important life matters.
Educating your patient and family on their care choices and allowing them to weigh the outcomes against the burdens of treatment, allows the patient dignity in deciding what's most important to them.
If your patient has a life-limiting terminal illness, explain what the disease progression will look like.
Review Advanced Directives and Life Sustaining Treatment Choices with your patients on an annual basis, at minimum.
Patients with an advanced illness should review their wishes with you on a more frequent basis.
Ask what they would do if they were no longer to make care choices for themselves. Then ask them to put it in writing.
Explain to your patient that you are not going to abandon them. Explain that you will provide the best care you can, and that may at some point will likely include Hospice.
Ask what's important
Ask you patient what's most important to them before recommending the next form of treatment.
Explain all treatment options, benefits, burdens, and outcomes.
It's likely when presented with choice, a patient and family will tell you what they value most.
Never say "Nothing more can be done". Instead, present the family with hospice as the next step in care.
Explain Hospice provides much greater care, but with a focus on comfort, and is delivered in a setting where the patient wants to be and surrounded by the ones they love.