Question

How influential are physicians’ decisions regarding end of life care and their associated costs? Is the decision to sign into hospice based upon medical advice, social issues, or some other factor? Why are U.S. urban Black nursing home residents less likely to avail themselves of hospice services?

Physicians’ decisions regarding end of life care and the associated costs are very influential. Although patients and their families make the ultimate decisions of what to do, the physicians guide the patient and their family by giving information about the care, treatment, and other options. The decision to sign into hospice is a combination of medical advice and social issues. Sometimes there is nothing more a physician can do to care for a patient. Other times, the family members are not capable of caring for the patient either, so the only choice for a patient at the end of life stage is to enter them into hospice. U.S. urban black nursing homes are less likely to avail themselves of hospice services because there is usually a racial difference in how hospice is perceived. Blacks usually want a more aggressive end of life care than other race. ( example )

Answer 1

Physician plays a vital role in the entry of a person into Hospice. Several factors are considered before this suggestion is taken.

At times if patient state is bad and physiciannis sure that he wouldn't come back; still family members would like to have the patient with them and this avoids the entry of the patient into the same. Family support is significant here; but not in every case. On the other hand, physician needs to take the decision to put in a hospice even if family is not ready to give time for the progress of a patient when it is doubtful.

Ultimately the decision of the physician matters in all these scenarios.

Lack of economical or psychological support from famiy also can push a patient into this condition.

In general all the external factors and condition of patient may place him into a hospice regardless of health condition.