Some of the most common misconceptions about hospice care involve when it’s appropriate for a patient to elect hospice services and what diagnoses qualify a patient for hospice. People often assume hospice is only for cancer patients, but that is simply not true. You may be surprised to learn that stroke patients also qualify for hospice services.
What is a Stroke?
Strokes are the number five cause of death and a leading cause if disability in the United States. A stroke is defined as a disease that impacts the arteries leading to and within the brain. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When this happens, part of the brain cannot get the blood and oxygen it needs, causing it and brain cells to die.
Stroke Warning Signs
The American Stroke Association uses F.A.S.T to help us identify warning signs of a stroke.
F = Face Drooping
If one side of the face is drooping or numb, this can be a common sign of a stroke. One way to help to determine this is by asking the person to smile. If their smile is uneven, that is an indication of face drooping caused by a stroke.
A = Arm Weakness
Another sign can be if one arm feels weak or numb. Ask the person to raise both their arms. If one arm drifts downward, it could be a sign of a stroke.
S = Speech Difficulty
Slurred speech is a third sign of a stroke.
T = Time to Call 911
If someone is showing these three warning signs of a stroke, call 911 immediately.
Other Signs and Symptoms
Other signs and symptoms of a stroke can include:
Numbness or weakness in the face, arm, or leg (especially on one side of the body)
Confusion, including difficulty speaking or understanding speech
Difficulty seeing in one or both eyes
Difficulty walking, including dizziness or loss of balance or coordination
Severe headache with no known cause
Stroke Risk Factors
Given the danger of strokes, it’s important to understand the different risk factors, including both those within and out of your control.
Risk Factors You Can Control
Some risk factors of stroke are within your control. These can include:
High blood pressure is the leading cause of stroke
Smoking may double stroke risk, specifically for African Americans
Diabetes
Diets high in saturated fat, trans fat, and cholesterol can raise blood pressure and increase your risk of a stroke
Physical inactivity
Obesity
High blood cholesterol
Other heart diseases
Sickle cell disease
Risk Factors Beyond Your Control
As with anything else, some stroke risk factors are beyond your control. These can include:
Age. The risk of having a stroke increases with age.
Familyhistory. You may be at higher risk of having a stroke if your parent, grandparent, or sibling has had a stroke.
Race. African Americans have a much higher risk of death from a stroke due to a higher risk of high blood pressure, diabetes, and obesity.
Gender. Women are known to have more strokes than men.
Prior stroke, TIA, or heart attack. A person who has had a stroke before is at a much higher risk of having another.
Hospice Qualifiers
Hospice can benefit patients who are in the terminal stages of a stroke. The following criteria could be indicators that it may be a good time to consider the additional support of hospice.
Received a Palliative Performance Score or Karnofsky score of 40% or less from a primary care physician
Requires assistance with activities of daily living (ADLs)
Unable to maintain sufficient fluid and caloric intake with a decrease in eating or drinking
Demonstrates progressive weight loss
If you are still unsure if your loved one qualifies for hospice, or if you have any questions about hospice for stroke patients, please don’t hesitate to contact us.
A life-limiting illness comes with a lot of difficult decisions to consider. One of those decisions is when it may be time to consider hospice care. This can be an intimidating decision to make, so we are sharing some tips to help you determine when the time is right.
Understanding Hospice
Hospice is an interdisciplinary approach to end-of-life care. When a patient and their family choose hospice, they are choosing to switch the focus from curative treatment to comfort care. This simply means the goal is now to manage the patient’s pain and other symptoms to keep them as comfortable as possible. Symptoms hospice can help treat include pain, shortness of breath, and restlessness.
Many people think hospice is a place. However, this is not true. Hospice care can be provided wherever the patient calls home, including their own home or a nursing facility.
Patients are generally considered to be eligible for hospice when a physician determines they have a life expectancy of six months or less.
Hospice Does Not Mean You’re Giving Up
One misconception is that when you choose hospice, you are giving up. This is not at all the case. Hospice is not just about the dying process, it’s about the end-stage of the life-limiting illness, as well. When you choose hospice for your loved one, you are choosing quality of life for them. No more treatments that make them feel sick in attempt to buy them more time. Just focusing on making sure they are comfortable and at peace for whatever time they have.
How to Know the Time is Right
So how do you know it’s the right time to consider hospice? Below are some of the common indicators:
Decline in functional status, cognitive status, and/or mobility
Abnormal weight loss
Frequent medication changes
Shortness of breath with minimal exertion or at rest
Recurrent infection
Frequent hospitalization or ER visits
Multiple falls
Increased assistance with ADLs (activities of daily living)
Increased weakness
Diet changes
Difficulty swallowing
Edema
Wounds
Pain
Remember, these indicators are just guidelines and do not replace a physician’s evaluation. If you think it may be time for hospice, talk to your doctor.