The end of a person’s life can bring up a range of emotions, and feelings of loneliness can be one of them. Especially for hospice patients who have no family support. While hospice agencies typically look for ways to care for the patient and provide support for the patient’s family, what happens if there are no family or caregivers? What can hospices do for older adults who outlive their loved ones?
According to the Journal of Pain and Symptom Management, patients who don’t have an available surrogate to make healthcare decisions on their behalf, and are without any support, are known as unbefriended patients.1 Below we explore some of the ways hospices can continue to be a source of strength and comfort for patients, even when they have no extended family to turn to.
Discuss Advance Care Plans
When a hospice patient doesn’t have an immediate family member to take the reigns of their care, it’s important to put together an advance care plan, so they know their needs and final wishes are being met. Creating an advanced care plan should take place even before a crisis situation presents itself. These outlined, formal plans may include a list of documents that include living wills, doctor orders, and advanced directives, just to name a few.2 It will help avoid any conflict or confusion at a time that’s already challenging as it is, and it can provide the patient with peace of mind knowing their own end-of-life wishes will be met.
Explore Options for Patient to Select Someone to Oversee Their Care
So there are no mishaps or misunderstandings along the way, it may help for hospices to encourage the patient to assess their final wishes with someone they trust. Perhaps it is a close friend or an individual who’s been a good confidante.3 Identifying someone who can oversee the patient’s care is a way to make sure the unbefriended patient has a trustworthy individual that can make decisions on their behalf should they become impaired.
Seek Available Assistance and Resources
Hospices can also look at what other resources are available to the patient, though it is worth noting that healthcare guidelines for unbefriended patient care vary from state to state. Per Hospice News, “many have enacted public guardianship programs, in which a state social services agency appoints an attorney to become the patient’s legal guardian.” For example, in Indiana, hospices can turn to a Volunteer Advocacy Program, whereby the attorney appointed as a guardian can assign a trained volunteer to make third-party decisions on behalf of the patient.4 However, assigning guardianship may not always be the best suited option, therefore, it’s important to discuss available resources with the patient, and also get their consent, before any decision is made.
At a delicate time when a patient may already feel vulnerable and alone, a hospice care team’s compassion is what can alleviate some of these uneasy emotions that may arise. Most of the time, an elderly patient just needs someone beside them who is willing to listen to their needs and honor their wishes, thus allowing them to be supported until the end of their life journey.
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1 Journal of Pain and Symptom Management, “Patients Who Lack Capacity and Lack Surrogates: Can They Enroll in Hospice,” October 4, 2014. https://www.jpsmjournal.com/article/S0885-3924(14)00155-9/pdf
2 & 4 Hospice News, “Hospices Adapt to Support Patients Without Family Caregivers,” June 12, 2019. https://hospicenews.com/2019/06/12/hospices-adapt-to-support-patients-without-family-caregivers/
3 Hospice Community Care, “Advance Care Planning,” December 2020.