A 78-year-old man with end-stage esophageal cancer is admitted to the hospital because he is very malnourished and failing to thrive. According to the patient's caregiver, he has been unable to eat or drink for the past three weeks. During that time, his weight plummeted from 72.6 kg (160 lb) to 63.5 kg (140 lb). His cancer has progressed to his lungs and liver. The patient does not want any further cancer therapy and states that he does not want any heroic measures or interventions to keep him alive. His doctor is thinking of referring him to hospice care. Which of the following is not a prerequisite for sending a patient to hospice care?

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Quizplus · Accepted Answer

Eductional Objective: When intensive, curative therapies are no longer useful or wanted, hospice care is generally offered to terminally ill patients with a prognosis of 6 months. Cancer patients make up the majority of persons getting hospice care, but those with other severe medical illnesses are also included (eg, end-stage cardiomyopathy, end-stage chronic obstructive pulmonary disease, pulmonary fibrosis). A 6-month prognosis must be supported by proof of permanent decrease in clinical and functional condition.
Hospice care is founded on the philosophy of compassionate care that prioritizes comfort and quality of life. A multidisciplinary team of nurses, social workers, chaplains, and a hospice physician who works closely with the patient's attending physician provides it. 
It can be delivered at the patient's home (home hospice care), a nursing home, or a hospice center. Hospice treatments include pain and dyspnea management, as well as psychological, spiritual, and grief counseling for patients and families.

A 78-Year-Old Man with End-Stage Esophageal Cancer Is Admitted to the Hospital