By Kathryn Ruscitto, Advisor
Thursday, October 21, 2021
It May Be Earlier Than You Think.
Helping anyone on their end-of-life journey is hard, and having a good support system for families is crucial.
I once watched a family struggle in the ICU to help their family member on the journey. I wondered if their physician had suggested hospice. Did they know they could seek palliative care support from hospice even if their loved one didn’t qualify for full-time hospice care? Maybe the family refused to have the conversation or maybe they just weren’t ready. What else might we have done to help them through such a difficult time?
Recently, I had the opportunity to interview Dr. Zaki Badawy, the Medical Director of Hospice & Palliative Care of Chenango County.
I asked him when a clinician should reach out to hospice. This is what he said:
“When a person is in the final stage of an illness … and clearly is in the last six months of life and not seeking life-prolonging care, the patient needs additional support to remain at home or in their current setting. If a patient does not meet the criteria for admission to hospice, they may still qualify for palliative care support. Hospice provides a team to support the patient, with 24-hour access to a physician. Patients can be accepted with Medicare, Medicaid, private insurance and under the alternate plan of care in most long term care policies.”
Many times, patients and families don’t wish to face this difficult conversation. How do we as healthcare professionals find the best way to engage? By being prepared with resources, or helping them do their own research. The AARP website has a wealth of resources on the subject.
Dr. Badawy says Medical Orders for Life-Sustaining Treatment (MOLST) from the New York State Department of Health is also part of the conversation. The initiative states:
Kathryn Ruscitto, Advisor
Zaki Badawy, MD
“The (MOLST) program is designed to improve the quality of care seriously ill people receive at the end of life. MOLST is based on the patient’s current health status, prognosis and goals for care. The discussion emphasizes shared medical decision-making that helps the patient understand what can and cannot be accomplished. The result is a set of medical orders that must be honored by all healthcare professionals in all settings.”
At the time a MOLST form is completed, maybe then patients and families will be encouraged to consider hospice in their planning.
Thank you to all the clinicians who choose this highly valued and honorable work. Dr. Badawy remarked that end-of-life care support is an underutilized service in our health system — and hospice teams have much to offer.
References for end-of-life conversations
- AARP: aarp.org-caregiving/basics/info-2020/end-of-life-talk-care-talk.html
- Chenango County: hospicechenango.org
- CNY and the Finger lakes: hospicecny.org
- Oswego County: health.oswegocounty.com/programs/1_hospice/index.php
- Cortland County: hospicare.org
- Oneida County: hospicecareinc.org
- National Hospice and Palliative Care Organization: nhpco.org