COPD Patients: Doctors Call for Earlier Hospice Referrals

By: Wilma Peterson, RN

According to the American Lung Association, Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the United States. Living with the distress and panic caused by difficulty in breathing with COPD can induce stress for both the patient and the family. Due to this, Doctors are beginning to call for earlier hospice referrals for patients with COPD. If accessed at the right time, hospice care can assist with symptom management, prevent unnecessary hospitalizations, and help patients achieve a better quality of life.

Patients with advanced COPD are eligible for hospice care, which is fully covered by Medicare, some private insurances, as well as assistance from Veterans Affairs. When the hospice benefit is elected, patients have access to the appropriate care and medications, allowing for more restful periods and easier breathing. Identifying these factors early can relieve symptoms such as anxiety, panic, labored breathing, and intractable coughing that are uncontrolled with regular medications and traditional therapies.

Factors to consider when discussing the appropriateness of a hospice referral for a COPD patient include:

1. The patient has a projected life expectancy of 6 months or less

2. All therapies, including medications and rehabilitation, have been exhausted

3. The patient has frequent emergency room visits and hospitalizations due to exacerbation of COPD

At this point, the patient is considered to be in the advanced stages of COPD, and the discussion for hospice and end-of-life care should begin.

Eight benefits of early hospice referral for those with COPD

Electing the hospice benefit early allows for the expertise of a focused team of professionals:

• Physician

• Nurses

• Social worker

• Chaplain

• Ancillary services

Hospice services are available 24/7/365. The hospice care team will provide medical, emotional, psychological, and spiritual support to the patient and family. Here are eight benefits of early hospice referral:

1. Early intervention. The earlier the referral is made, the more time it gives the patient and their family to choose the right hospice company and be a part of the care plan.

2. Managed care. A physician leads the hospice care team and can order the appropriate medications and therapies and cater to an individualized care plan for each patient.

3. Skilled Nurses. A registered nurse will meet with the patient and family, and can admit the same day. The nurse will also reconcile all medications, put together a plan that focuses on managing symptoms, and provide relief of pain and respiratory distress.

4. Hospice Aides. Health aides assist with normal daily activities:

• Washing

• Grooming

• Dressing

• Ambulating safely

• Other household chores

1. Medical Social Worker. A social worker will assist with accessing support in the community, such as respite care and other services.

2. Chaplain. Clergy to meet the patient and their family’s psychological and spiritual needs, assisting them through the end-of-life and grieving process.

3. Ancillary services. Other ancillary services like physical therapy and occupational therapy, strengthen muscles to assist with safety and allow for a sense of independence.

4. Respite Care. Allows time for self-care and rest, which can help with a change in attitude and mindset in caring for your loved one.

Living easier with hospice care

Early hospice referrals means early management of symptoms by:

• Having the appropriate therapy and staff when needed

• Avoiding the stress of emergency exacerbations and unnecessary hospital visits

• Providing a more individualized approach to the patient and caregiver

• Alleviating stress to allow time for future planning or ability to spend quality time

An early hospice referral can provide extra support for both the caregiver and the patient. If you or a loved one is struggling with COPD, consider the benefit of hospice services.