Patients benefit from getting hospice care earlier

March 4, 2013 

Dr. Todd Coté is chief medical officer of Hospice of the Bluegrass.

  • At issue: Feb. 7 Bloomberg News article, "Hospice use on the rise; observers say many of the dying aren't switching to home care soon enough"

A Feb. 7 article, "Hospice use on the rise," highlighted a 2009 study noting that although hospice use among elderly patients has increased from 22 percent in 2000 to 42 percent in 2009, some patients still do not receive hospice care until the last few days of life. This study reinforces what Hospice of the Bluegrass has experienced during the past few years.

For 35 years, Hospice of the Bluegrass, nationally known as a leader in hospice care, has provided care to terminally ill patients and their families in 32 Central, southeastern and Northern Kentucky counties. In 2012, Hospice of the Bluegrass served more than 5,000 patients and families.

Patients are considered eligible for hospice if they have been given a prognosis of six months or less to live, but about half of patients die within two weeks of admission. Consequently, the patient and family might not receive full advantage of the scope of hospice services.

It is clear that patients benefit from choosing hospice as early as possible in a serious illness. In 2010, the New England Journal of Medicine reported, "With earlier referral to a hospice program, patients may receive care that results in better management of symptoms leading to a stabilizing of their condition and prolonged survival."

Study after study also indicates that people want to die at home surrounded by friends and family and free of suffering. However, some people will continue to die in hospitals, so it is important to offer high-quality end-of-life care there. To address the problem of increased hospitalizations at end of life, Hospice of the Bluegrass has partnered with many health systems in our service area to work with acute-care providers to offer services in the hospital for patients who need hospice in the last days or hours of life.

To ensure individuals receive the end-of-life care they want and avoid unwanted hospitalizations, it is important to make wishes known through advance-care planning. Research all the options, talk to your health care team to discuss likely outcomes of your disease progression and establish an advance directive to make your wishes clear.

People are living longer and have more options for care. It is critical to educate yourself and your family about end-of-life care options and your preferences long before you need them. Some tools to get started can be found at It might seem like a hard conversation to have, but the benefits are enormous. The number one comment we receive from families after a loved one's death is, "I wish we had called Hospice sooner."

For information about hospice care, call (859) 296-6100 or go to

At issue: Feb. 7 Bloomberg News article, "Hospice use on the rise; observers say many of the dying aren't switching to home care soon enough"

By Dr. Todd Coté

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