Hospice Patients Alliance: Consumer Advocates


DIAGNOSING A TERMINAL ILLNESS:
IS IT SIX MONTHS OR LESS?

According to Federal laws governing hospice, a physician can only certify a patient as "eligible" for hospice benefits (under Medicare) if the patient's life expectancy can reasonable be expected to be six months or less. This is simply a statistical average life expectancy given a specific diagnosis...it may or may not be true for any one individual patient. While some patients may live much longer than six months, there are others who only live two weeks or so. Each patient's situation must be evaluated on an individual basis.

It is common for hospice staff to hear families' accounts of "predictions" about how long their loved one would live. While some of these predictions are quite accurate, some are not, and debates arise as to whether or not predictions should even be made. The problem is not easily resolved, since most of us would be the first to ask the physician, "how long will it be?" And the physician is placed in the awkward position of predicting that which cannot always be accurately known, even though he or she wants to give the patient and family the best hope. However, it is certain that nobody really knows for sure, and it's not over till death actually occurs. We encourage you not to rely too much on predictions, and to make the best of the time that is left, however long it may be.

Hospice staff are well aware of some patients who have lived well beyond the six months period. What happens then? Hospice care continues as long as needed to meet the patient's and family's needs. The physician simply "re-certifies" the patient for another period of time and services continue.






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