How do you counsel patients/families whose goals of care are clearly aligned with a comfort-focused, end-of-life approach, but who are hesitant to formally enroll in hospice?  

Hospice sounds like a 4-letter word to a lot of families! I find it important to distinguish the philosophy of comfort care vs. the benefit package associated with enrolling in hospice. Some people are able to be provided end-of-life comfort care without electing the hospice benefit, and that is fin...

So when I see this question in the “hospital medicine” section, and the question has a “but” in it, I focus on the statement after the “but”. (If interested, see this link on Meaningful Conversations for medical students.) “....but who are hesitant to forma...

First, I recap their health situation in realistic terms, but I ask how much the patient wants to know about the prognosis (especially if the person asking is a family member). I ask if patients have a living will and what it says. I ask them (if they have one) to have it entered in their chart. I d...

It is already a strength that patients/families express their goals, already aligning with a comfort-focused, end-of-life care approach. Oftentimes, the barriers in emotion and system resource practical considerations make people hesitant to opt for hospice care. The concept of hospice care can be d...