Hospice Patients Alliance: Consumer Advocacy


When patients can no longer breathe on their own, there is a medical option of using a ventilator to keep the patient breathing. In hospice care, the emphasis is on maintaining patient comfort but not on attempting to cure a terminal illness. In many cases, a patient stops breathing when many organs within the body fail due to disease. This is normally the time of death, but in some cases, a patient may choose to be kept alive on a ventilator.

In certain diseases, the patient is fully aware and conscious, but the muscles used for breathing no longer function properly. Diseases of the nervous system such as A.L.S. (Lou Gehrig's Disease) can eventually cause total inability to move any part of the body, even the muscles of breathing. Some A.L.S. patients choose to be placed on a ventilator in order to stay alive.

Certainly, the decision to use a ventilator is a difficult one to make. Quality of life is severely compromised by certain diseases, yet some choose to extend their lives through the use of a ventilator. If the patient wishes to be placed on ventilator life support, then the attending physician should be consulted before such life support becomes necessary.

Deciding to use a ventilator may affect the hospice benefits available and also may affect the physician "certification" for hospice. You will need to speak in detail with the physician and ask if he or she would still be able to certify you as eligible for hospice if you choose to use a ventilator. If the physician states that he or she would no longer certify the patient as "terminal" if the patient would live indefinitely on the ventilator, then other health care benefits may be reinstated such as regular Medicare, Medicaid or private insurance.

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