Starting the Hospice Conversation

By Joyce Baldrica, President and CEO of the VNA of the Treasure Coast

and Nightingale Private Duty Nursing


In life we prepare for everything… college, marriage, children, and retirement. Despite the conversations we have for these important milestones, rarely do we have conversations about how we want to be cared for at the end of our lives.


Research shows that Americans are clear about what they want when it comes to end-of-life care. They want to remain at home with control of their treatment options, effective pain and symptom management; along with supportive services that aide with personal, spiritual, and emotional care.


Deciding when is the right time for hospice is a question that all of us will one day face. Hospice is traditionally thought to be for patients who are in the last six months of life, but some patients stay on hospice services for years if their disease process is slow. Because hospice is focused on living, people who utilize hospice services early in the course of an illness have more time to discuss goals and create an optimal plan of care designed around patient and family wishes.


Families often avoid the conversation or delay approaching the subject out of fear or uncertainty. Furthermore, it is never easy to begin a conversation with a family member who has been diagnosed with a life-limiting illness about hospice. However, the earlier you can have this conversation, the better the chances are for your loved one to be able to stay where they are, whether it’s at home, in an assisted living, or skilled nursing facility. Talking is the single most important thing that you can do to prepare for this journey.


Talk with your doctor about the treatment plans ahead and how these match goals and wishes for you – or your loved one. Your doctor can help you decide if it is time for hospice. You can also contact your local hospice provider and request an evaluation. Hospice teams do this work every day. Hospice nurses and social workers can answer your questions, dispel the myths, and support you and your family in meeting your end-of-life goals.


Every moment is precious – especially at the end-of-life. Starting the conversation early can ensure that your choices are heard. It also means that when time becomes short, it can be spent doing what you most enjoy and not making last minute decisions. Talk about your wishes while you are in good health so you will be prepared.


A health crisis can happen to anyone at any time. Don’t wait. Start the conversation today.



VNA provides compassionate, innovative care of the highest quality, setting the standard for patients and caregivers needing home health, hospice, and community health services.