How should you handle a patient requesting hospice referral?

• A. Assess goals, provide information, involve family, coordinate with social work and palliative care
• B. Refuse and continue curative treatment
• C. Schedule hospice without patient input
• D. Refer only after physician approval

Answer: (A)

When a patient requests hospice, the key is to center the conversation on the patient’s goals and coordinate a team-based plan to support those goals. Begin by exploring what matters most to the patient: what quality of life looks like, acceptable burdens of care, and desired level of intervention. Provide clear, compassionate information about what hospice offers, including symptom relief, support for daily living, and how it fits with prognosis and current care. Involve the family as appropriate to ensure they understand the patient’s wishes and can support decision-making, while always honoring the patient’s autonomy.

Then bring in the right help: coordinate with social work to review benefits, insurance coverage, and practical needs like transportation and home support. Include the palliative care team to help with symptom management, ongoing goals-of-care discussions, and advance care planning. This multidisciplinary, patient-centered approach ensures the patient can make an informed choice and access hospice in a timely, appropriate way.

Refusing discussion or continuing curative treatment by default, scheduling hospice without input, or waiting for physician approval alone would not respect the patient’s preferences or streamline a plan aligned with their values.