Hospice services are often not thought about until very late in the course of an illness.  At Smoky Mountain Home Health & Hospice we often hear the families of our patients say things like, “We wish we would have called you months ago!”   Too often families shy away from even considering the Hospice choice even though they have a loved one facing a life limiting diagnosis.  This may be because of a misunderstanding about Hospice care – what it is, when to start services, and how it can be of benefit to your loved one and to your family.

Hospice care is an encouraging kind of care – providing comforting and compassionate support by a team of professionals who work together to make one’s final journey in life a better one.  When Hospice care is started earlier rather than later – there is more time to reap the many benefits and receive the kind of support you need in this difficult time.

It’s never an easy decision; to either keep pursuing active medical treatments when the benefits of such are dwindling – or – going down a different path of managing the disease process, symptoms and pain while striving to maintain dignity and comfort in one’s final months.  
Perhaps you are wondering if it is time to consider Hospice services for your loved one. Think of your loved one, their disease course and current situation.   Then use the following questions as a guide.   You may begin to see a need for a different kind of care – Hospice Care.
  1. Does your loved one’s condition seem to you to be continuing along on a path of decline over time?
  2. Has your loved one had several Emergency Room visits and/or hospitalizations in the last 6 months or so?
  3. Have there been more appointments or calls to the Dr’s office?
  4. Is your loved one sleeping (in bed or chair) more and more?
  5. Is your loved one losing their ability to walk; becoming unable to get in or out of a chair without hands on assistance; or have they become bed-bound?
  6. Does your loved one need increase assistance with eating, dressing, bathing or toileting?
  7. Has your loved one had several falls in recent months?
  8. Is your loved one losing weight; eating or drinking less?
  9. Is pain increasing and now more pain medication is required?
  10. Do you notice your loved one getting short of breath even while they are at rest?
  11. Has your loved one’s Physician signaled that the disease process is now life limiting, terminal or not responding to treatments?
  12. Is your loved one expressing dismay and/or voicing their own desire to discontinue ongoing futile medical treatments, chemotherapy, radiation, dialysis, ER visits and hospitalizations?
  13. Have you and your loved one had a frank discussion with the Physician about prognosis and the appropriateness to at least begin to consider Hospice Care?
  14. Are you and your loved one emotionally ready and open to being assessed for Hospice eligibility?

Every patient and diagnosis are different.  Hospice Care is often chosen by patients with a diagnosis of Alzheimer’s and other forms of dementia, lung disease, cancer, heart disease, renal failure, liver disease, cerebral infarction, ALS and AIDS.   This is by no means an exhaustive list.  A patient may have multiple diagnoses as well.  A patient must ‘qualify’ for Hospice Care according to established eligibility requirements. The patient usually has coverage for Hospice services such as Medicare, Medicaid or an insurance plan with Hospice benefit. Your loved one’s diagnosis must be terminal and with a prognosis of 6 months or less – if the disease runs its normal course.  This is where a physician’s knowledge of the patient and his/her best judgment comes in.  Patients often live longer than 6 months – but they must continue to show declines in their condition to keep on qualifying for Hospice Services.  Our services can be offered to your loved one in their home, assisted living facility, memory care unit, nursing home or within a hospice residential facility.


If you feel that it is appropriate to consider Hospice – then start the conversation.   Speak to your loved ones Physician about this option if you have not yet done so.  Discuss it with your loved one and other important decision makers.  Call Smoky Mountain Hospice for an assessment to determine eligibility.  Ask questions and get more specific information. Let us tell you about the many benefits of the care we can provide.   Then you can decide and feel confident that this is a good choice with comfort and symptom management in mind.  Once a decision is made, we are able to handle the admissions process.


A decision ‘for’ Hospice is made after getting to a place of acceptance regarding your loved one’s condition and prognosis – and also realizing that the goal of care is now different.  Your decision is to move from medical interventions and attempts to cure – to a new goal of being made as comfortable and pain free as possible; all while optimizing the remaining time left in one’s life.  Painful and futile treatments often with sickening side effects and the indignity of being hooked up to tubes and machines is left behind.  End of life will come in a familiar environment with respectful support.   Your loved one and family will benefit from the ongoing care of an interdisciplinary team that includes Doctors, Nurse Practitioners, Nurses, Nurses’ Aides, Social Workers and Chaplains. All of us at Smoky Mountain Hospice work together to meet your unique medical, emotional and spiritual needs.  We look forward to being of service to you and your loved ones.

All of us at Smoky Mountain Hospice work together to meet your unique medical, emotional and spiritual needs.  We look forward to being of service to you and your loved ones.