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For leaders who make decisions on data, hospice care presents an odd contradiction: It may be the most evidence-backed choice in health care, and yet it’s consistently the one families make too late.
Nationally, roughly half of all patients who enroll in hospice are enrolled in their final two weeks of life. It’s timeline set not by medical need, but by how long it takes a family to pick up the phone.
Liz Russell, RN, sees that gap up close every week. As clinical liaison for Hospice in His Care, a family-owned hospice that’s served the Baton Rouge area since 2004, she’s watched the same pattern repeat across hundreds of households.
“It’s just gotten a bad name for itself,” Russell says, “and it’s sad, because hospice does so much for families if it’s started at the right time.”
That reputation problem has a real cost. Russell points to congestive heart failure patients as a clear example. Studies show that patients enrolled early in hospice live an average of 81 days longer than those who wait until the final two weeks.
Earlier enrollment brings a dedicated on-call nurse, individualized visit schedules that flex with a patient’s condition, and faster access to medication. With that kind of responsive, coordinated care, a manageable condition is less likely to spiral quickly into a hospital admission.
OVERCOMING A NEGATIVE CONNOTATION
Part of the problem, Russell believes, is the word itself, which many people associate with death on the doorstep rather than a graceful end of life. She’s started using different language with families.
“I like to call it a higher level of care,” she says, walking through everything that comes with it: nursing visits, medical equipment, supplies from oxygen to wound care, and around-the-clock phone access at no direct cost to the family under Medicare, Medicaid, or most private insurance.
For executives evaluating benefits or advising employees through a family health crisis, that’s a distinction worth knowing. Hospice isn’t the end of care. It’s an increase in it.
One of the more counterintuitive aspects of hospice, particularly for a decision-driven audience, is how much control it ensures rather than removes. Enrolling isn’t a binding commitment. Families can change providers, scale services up or down, or cancel altogether if circumstances shift.
“Just because you sign up does not mean you’re tied into hospice forever,” Russell says. “You are in control of your care at all times.”
Hospice in His Care offers several tiers depending on need: routine home visits from nurses on call around the clock; inpatient care for symptoms too acute to manage at home; short-term continuous care during a crisis; and five-day respite stays that give exhausted family caregivers a planned break.
That last option addresses a workforce issue many companies underestimate. Caregiver burnout is a real driver of absenteeism and turnover among employees managing a family member’s illness, and most don’t know a structured break is available to them.
DO YOUR HOMEWORK BEFORE YOU COMMIT
Russell encourages families to treat the choice of provider like any other vendor decision. With roughly 40 hospice companies operating in the Baton Rouge area, she recommends interviewing two or three before committing, regardless of what a hospital or physician recommends.
“It is your choice,” she says. “Some doctors like to push their own companies, and I understand that, but it is really your choice.”
Communication is part of the model, too. When a patient’s condition begins to decline, Russell’s team increases visit frequency and briefs the family in plain terms about what’s changing and why. Doing so reduces panic and prevents unnecessary trips to the emergency room.
It’s a version of a principle any executive would recognize: uncertainty, more than the underlying situation itself, is often what drives poor decisions. Clear, timely information tends to produce calmer ones.
For business leaders navigating this decision for an employee, a family member, or themselves, Russell’s advice comes down to one line she repeats often: Knowledge is power. The earlier families understand their options, the more control they keep, and the better care their loved ones have.
Learn more at HospiceInHisCare.com.
