Some neurological diseases cause a slow decline over months or years. Others, like stroke, can cause abrupt loss of function. Either way, it can be difficult to determine when the time is right for hospice. In general, hospice patients are thought to have six months or less to live. When improvement is unlikely and a decision is made to discontinue the use of a feeding tube or breathing machine, hospice coma care is likely to benefit the patient and family.

 

Only a doctor can make a clinical determination of life expectancy. However, look for these common signs that the disease has progressed to a point where all involved would likely benefit from hospice services:

 

Patients with stroke:

• Coma

• Persistent vegetative state

• Severely reduced level of consciousness

• Continual decline in clinical and functional status

 

Patients with coma:

• Physical deterioration despite nutrition and hydration

• Desire to avoid feeding tubes and mechanical ventilation

 

Patients with Parkinson’s or MS:

• Severe difficulty breathing

• Severe difficulty swallowing

 

All neurological diseases:

• Rapid progression to wheelchair- or bed-bound

• Barely intelligible-to-unintelligible speech

• Need for pureed foods

• Need for major assistance with eating and personal care, or total dependence on others for these activities.

 

The patient’s neurologist or personal physician may recommend hospice when the time is right. But patients and family members often must act as their own advocates to receive the care they need. You, your loved one or your physician may request an evaluation to see if hospice is an appropriate option for care.