Criteria for Discharge and Readmission to Hospice Care

Hospice care is a support system designed for patients with serious illnesses who have a prognosis of six months or less of life if the illness runs its normal course. However, the conditions for discharge from hospice, as well as the possibility of readmission, can be somewhat nuanced.

Discharge Criteria for Hospice Care

The decision to discharge a patient from hospice care typically depends on the prognosis and documented medical conditions of the patient. Here are the key points to consider:

Death Confirmed: The primary criterion for discharge is the actual passing of the patient. If the patient has died, hospice care naturally ends. Undiagnosable Condition: If a patient's condition is no longer diagnosable or untreatable by standard medical methods, they may be considered for discharge if other palliative care options are more suitable. Improvement in Medical Status: Patients may be discharged if they experience a significant improvement in their medical status, such as recovery from a previous serious illness or injury. This would typically require the support of medical evidence and a reevaluation of their condition. Relocation or Out-of-State Care: Sometimes, patients might be discharged due to their relocation to another region where hospice care is not readily available. In such cases, they might seek care in a different setting or manage their condition with local providers.

Readmission to Hospice Care

While hospice care is typically a one-time provision, it is not uncommon for patients to be readmitted if their health condition deteriorates again. The following situations may warrant readmission:

Second Outpatient Stay: Patients who have undergone hospice care and later experience a relapse or worsening of their condition may be readmitted. This is often decided based on new medical evaluations and the patient's current prognosis. Clinical Progression of Disease: If a patient's condition recurs or significantly progresses, they may need to be reassessed and potentially re-enrolled in hospice care. Change in Medical Prognosis: If the patient's healthcare provider revises the prognosis and determines that less than six months remain, they may be readmitted.

A Personal Experience

My mother faced a series of health challenges, including a heart condition (COPD), several Transient Ischemic Attacks (TIAs), and at least two strokes. Despite these setbacks, she was not a candidate for any surgical interventions due to her previous experience with respiratory arrest during anesthesia. The eligibility criteria for hospice care mandated that the patient's diagnosis could potentially cause death within six months.

During her lifetime, my mother qualified for hospice care three separate times, and each time, her condition worsened over the six-month period, necessitating her continuous care through hospice. It was a difficult but necessary provision to ensure her comfort and quality of life in her final stages.

A common misunderstanding is that once a patient is discharged from hospice care, they cannot be readmitted. However, this is not always the case. If a patient's medical condition reverses itself or worsens to an extent where hospice care is again necessary, they can be readmitted to hospice.

It's crucial for healthcare providers and families to closely monitor a patient's condition and discuss any changes with their hospice team to ensure appropriate care throughout their journey.

Related Keywords: hospice care, discharge criteria, readmission to hospice