Can A Stroke Victim Receive Hospice Care?

There are two kinds of major, potentially life-threatening strokes. In an Ischemic stroke, a blood clot forms that reduces or blocks blood flow to the brain. In a hemorrhagic stroke, a blood vessel in the brain begins to leak or bursts suddenly.

With both types of stroke events, the short and long-term outcome depends largely on how quickly and how well the stroke is treated.

What happens after a stroke?

Unfortunately, many people who experience a stroke do not get treatment in time and face long-term consequences as a result.

After a stroke, it can take a few weeks or months to determine whether recovery is possible, or whether the stoke victim is going to experience an irreversible decline.

Typically, following a stoke, the first weeks or months are spent in a hospital. There, the stroke victim can receive treatment aimed at helping them to recover and go on to lead a life of reasonable quality. This is the goal of hospitalization.

If the stroke victim makes progress toward recovery in the hospital, the family and the doctors may make the decision to move the patient to a skilled nursing or rehabilitation facility. From there, it is hoped that the patient will recover enough that they can go home.

Some stroke victims do manage to recover enough to go home. Others recover somewhat but still need a higher level of care than can be provided at home. In this case, they typically enter a nursing facility.

But it may also turn out that, despite all medical efforts, there is nothing that can be done to reverse the effects of the stroke. Unfortunately, sometimes a stroke victim makes little no progress toward recovery in the hospital setting and continues to decline. In this case, the doctors and the family may begin to discuss hospice care.

What are the requirements for Hospice care for stroke victims?

To be eligible for Hospice care under Medicare guidelines, a physician must certify that the consequences of the stroke are likely to lead to death within six months. They must also certify that medical treatments no longer have a chance of leading to any level of recovery.

Whether or not a stroke victim is eligible for Hospice care is a decision that can only be made by the physician.

Some instances where a physician may determine that a patient is a candidate for Hospice care are if a stroke patient:

• is unconscious all or most of the time
• cannot eat or take fluids
• cannot perform any voluntary physical acts such as lifting an arm, talking, or walking
• cannot recognize people
• cannot understand simple directions
• cannot control bladder or bowel functions.

If doctors see no progress in any of these areas or see a steady decline, then they may conclude that the person is going to die within six months despite any medical treatment.

At that point, since there is nothing more a hospital can do to help with recovery, the goals of medicine change. They go from treatment leading to recovery to treatment making the person’s inevitable death as comfortable, pain-free, and caring as possible. This is what hospice care is dedicated to 100%.

What happens once it is determined that Hospice care is necessary?

Hospice care can be given in a wide range of places. It may be in a nursing home, in a hospice inpatient facility, at home with the family, or in some cases in a special hospital ward dedicated to hospice.

The decision on where the person can receive the best hospice care is made with the involvement of the doctors, the Hospice staff, the family, and perhaps other specialists such as a social worker and in some cases a spiritual counselor.

The Hospice placement decision is not made lightly. It always made with the goal of providing the best care for the dying person.

Once a placement has been determined, the team that will work within the selected hospice setting, in whatever location is deemed best for the patient. The team will work together to ensure that the patient receives the best possible support and care.

It can be very difficult for families to accept that there are no longer any treatment options available for their loved one. However, once it has been determined that switching to Hospice care is best, the family will no longer have to spend a lot of time dealing with insurance issues or making major medical decisions. Hospice care frees family members up to spend most of their time loving, supporting and caring for their family member.