When it comes to hospice care, one common question that arises is whether terminally ill patients should continue seeing their regular doctor or specialists. As an experienced hospice nurse, I have witnessed the benefits and challenges of maintaining these relationships. In this article, we'll explore the pros and cons of hospice patients still visiting their general practitioners and specialists from the perspective of patients and their families.
The Importance of Continuity of Care
Continuity of care plays a vital role in the overall well-being of hospice patients. It ensures that the patient's medical needs are adequately addressed and their comfort and quality of life are optimized. Here are some points to consider:
1. Familiarity and Trust: Patients often have an established relationship with their primary care physician and specialists, which can create a sense of trust and comfort. Familiarity with their healthcare providers makes patients feel more comfortable and confident in discussing their concerns and symptoms.
2. Comprehensive Care: General practitioners and specialists have expertise in specific areas of healthcare, enabling them to provide a comprehensive approach to managing the patient's medical conditions. While hospice care focuses on comfort and quality of life, there may still be aspects of the patient's health that require ongoing attention from specialists.
3. Expertise and Collaboration: Specialists possess in-depth knowledge and experience managing specific conditions. Consulting with these experts can provide valuable insights and guidance on symptom management, medication adjustments, and other relevant aspects of care. A collaborative approach between hospice teams, primary care physicians, and specialists also ensures coordinated and holistic care.
Pros of Continuing Care with Regular Doctors and Specialists
Despite the unique focus of hospice care, there are several benefits to maintaining connections with regular doctors and specialists:
1. Holistic Approach: Continuity of care allows for a comprehensive and integrated approach to the patient's healthcare. The collaboration between hospice teams, primary care physicians, and specialists ensures that all aspects of the patient's medical conditions and symptoms are addressed effectively.
2. Expert Guidance: Specialists can provide expert guidance and recommendations for symptom management and pain control, drawing on their specialized knowledge. This expertise can be invaluable in enhancing the patient's comfort and quality of life during their end-of-life journey.
3. Familiarity and Trust: Patients often feel more comfortable discussing their medical concerns and symptoms with healthcare providers with whom they have an established relationship. This familiarity fosters trust and promotes open communication, allowing for better understanding and tailored care.
4. Emotional Support: Regular doctors and specialists have developed rapport with patients and their families over time. This emotional connection can provide much-needed support during challenging times as patients and families navigate the complexities of a terminal illness.
Cons of Continuing Care with Regular Doctors and Specialists
While there are benefits to maintaining connections with regular doctors and specialists, it's essential to consider potential challenges:
1. Time and Logistics: Frequent visits to multiple healthcare providers may be physically demanding and exhausting, depending on the patient's condition and mobility. Balancing these appointments with the need for rest and comfort can be challenging for the patient and their caregivers.
2. Conflicting Opinions: When multiple healthcare providers are involved, there may be differences in treatment approaches and recommendations. Divergent opinions can create confusion for the patient and their family, making it essential to foster open communication and ensure all care providers are working towards the patient's best interests.
3. Treatment Burden: Frequent doctor visits and treatments can be physically and emotionally burdensome for patients who may already be dealing with fatigue, pain, or other symptoms. It's essential to weigh the benefits of each visit against the potential impact on the patient's comfort and overall well-being. Furthermore, most healthcare practitioners are not trained in end-of-life symptoms. This leads to the conflicting options mentioned above as they may try to treat numbers vs. the person to extend life via uncomfortable means vs. focusing on comfort.
4. Emotional Burden: Continuously engaging with multiple healthcare providers can be emotionally draining for the patient and their family. Dealing with medical decisions, appointments, and potential uncertainties can contribute to additional stress and anxiety during an already challenging time.
5. Financial Costs: Seeing regular doctors and specialists may have financial implications. It's important to consider the associated costs of appointments, tests, medications, and treatments and evaluate whether the benefits outweigh the financial burden.
I cannot stress #5 — financial costs — enough for patients and families. There are no bills from the hospice provider, and there may be a high price to see regular doctors and specialists, where the patient and family may be under the false premise that these, too, will be included as part of the hospice benefit. Never go in with the assumption that the visit will be covered by the hospice. I've had patients whose families were surprised with over $30,000 in medical bills they did not anticipate.
Finding a Balance: Communication and Collaboration
Effective communication and collaboration are key to navigating the complexities of hospice care while maintaining connections with regular doctors and specialists. Here are some strategies to ensure a balanced approach:
1. Open Dialogue: Encourage open and honest communication between the patient, their family, hospice team, primary care physician, and specialists. Sharing concerns, preferences, and goals of care helps create a unified approach that addresses the patient's unique needs.
2. Care Coordination: Establish a care coordination system, ensuring that information is shared among all healthcare providers involved in the patient's care. Regular meetings or consultations can help align treatment plans and provide a cohesive approach to symptom management.
3. Prioritizing Comfort: Hospice care's primary focus is optimizing the patient's comfort and quality of life. Regular doctors and specialists should align their recommendations with these overarching goals, prioritizing symptom management and emotional well-being.
Conclusion
Connecting with regular doctors and specialists can benefit hospice patients and their families. From comprehensive care to expertise and familiarity, these relationships can enhance patients' overall well-being during their end-of-life journey. However, balancing the practical considerations and emotional burden multiple healthcare providers can impose is essential.
By fostering open communication, collaboration, and a shared focus on comfort and quality of life, patients can receive the best possible care, incorporating the expertise of all healthcare providers.
