Editor's note: Gary McCarragher is a hospice physician in Pasco County who thinks more people would seek palliative care near the end of life if they better understood hospice. Last time, he looked at who is eligible for hospice care. Today, he's debunking misconceptions about the rights and privileges of hospice patients. To see his first column, go to TampaBay.com/health.
MISCONCEPTION: Hospice patients are required to sign a Do Not Resuscitate (DNR) order.
TRUTH: Patients are under no obligation to sign a DNR form. Given their circumstances — to be hospice eligible, you must have a terminal diagnosis and a life expectancy of less than six months — most patients have a DNR. But some patients choose not to. We do educate patients as to what is involved in cardiopulmonary resuscitation (CPR), but if a patient wants to be resuscitated, their wishes will be honored without affecting their hospice care.
MISCONCEPTION: Hospice patients are not permitted to call 911, go to a hospital emergency room, or be admitted to hospital.
TRUTH: Calling 911, and seeking ER and hospital treatment are certainly all permitted.
However, when you become a hospice patient, you are agreeing to a palliative treatment course that emphasizes comfort and quality of life measures, and to involve the hospice on your plan of care. So when a crisis occurs for a patient who is at home or in a care facility and has signed a DNR, we ask that the hospice be called first. An emergency visit by a hospice nurse and/or doctor can usually take care of most issues.
For patients who go into cardiopulmonary arrest and have stated they want to be resuscitated, 911 should be called first. Then hospice should be contacted.
MISCONCEPTION: Hospice patients must end their relationship with their primary care physicians and specialists.
TRUTH: Hospice welcomes and encourages collaboration between the patient, their primary care physician, specialists and the hospice physician. Patients may continue to see their own physicians in their medical offices, the hospital, chronic care facility, at home, or a hospice facility. These physicians can all bill for any services rendered to the patient.
NEXT TIME: Treatment Options and Care Plan Philosophy
Dr. Gary McCarragher received his medical training at McGill University and the University of Ottawa and was a gastroenterologist in Brooksville for 18 years before going to work for Hospice and Palliative Physician Services, which contracts with HPH Hospice in Pasco, Hernando and Citrus counties. Follow him on Facebook and Twitter (drgarymac), or at www.garymccarragher.com.