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Understanding Hospice Care Eligibility: Who Qualifies?

Updated: Jul 25, 2023

Hospice care focuses on enhancing the quality of life for patients with health challenges providing compassionate end-of-life care. If you're in San Diego and wondering who is eligible for hospice care, this blog post aims to shed light on the criteria and guidelines.

Eligibility Criteria for Hospice Care in San Diego:

Prognosis: To be eligible for hospice care, an individual must have a life expectancy of six months or less, as determined by a physician's clinical judgment. This prognosis is based on the underlying condition and the progression of the illness.

Diagnosis: Hospice care is typically provided to individuals diagnosed with a terminal illness or a condition that is no longer responding to curative treatments. Common diagnoses include advanced cancer, end-stage heart or lung disease, Alzheimer's disease, Parkinson's disease among others.

Decline in Functional Status: The individual's functional status is considered when assessing eligibility for hospice care. This refers to the ability to perform activities of daily living, such as eating, bathing, dressing, and mobility. A significant decline in functional status is often an indicator of a person's need for hospice services.

Palliative Needs: Hospice care is focused on managing symptoms and providing palliative support. Eligibility may be determined based on the presence of severe pain, uncontrolled symptoms, or a need for assistance with medication management, symptom control, or emotional support.

Willingness to forgo curative treatments: Choosing hospice care means opting for comfort-oriented care rather than curative treatments. Individuals must be willing to forego aggressive therapies and treatments aimed at curing the underlying illness.

Medical Certification: A physician's certification is required to confirm eligibility for hospice care. The attending physician, in consultation with the hospice medical director, should determine that the patient meets the criteria for hospice care.

Accessing Hospice Care in San Diego:

Once it has been determined that an individual meets the eligibility criteria for hospice care, accessing services in San Diego can be initiated through the following steps:

Consultation: Discuss the possibility of hospice care with the attending physician or medical team. They can provide information on local hospice providers and help coordinate the referral process.

Referral: A formal referral is typically required to initiate hospice services. The attending physician or medical team will collaborate with the chosen hospice provider to complete the necessary paperwork and share medical records.

Assessment: Upon receiving the referral, a representative from the hospice provider will conduct an assessment to evaluate the individual's specific needs and develop a personalized care plan.

Hospice Services: Once accepted into hospice care, a team of healthcare professionals, including doctors, nurses, social workers, and counselors, will work together to provide comprehensive care and support. This includes managing pain and symptoms, emotional and spiritual support, assistance with activities of daily living, and counseling for patients and their families.

Divine Light Hospice offers compassionate support to individuals and their families when they need it most and where the patient resides. Eligibility for hospice care is determined based on various factors. By understanding the eligibility criteria and accessing hospice services in San Diego, individuals and families can find comfort, dignity, and support during a difficult time.

Call us to help you determine your eligibility: (858) 365-8580

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