HOPE Guidance Manual v1.02, Section F: Preferences

Section Intent

Ite

ms in this section pertain to the hospice patient’s preferences regarding life-sustaining treatments and

spiritual care. Preferences are best obtained directly from the patient, or the caregiver/responsible party, if the

patient cannot self-report. The items in this section do not represent an exhaustive list of patient preferences that

hospices should consider. Completing this section does not replace a thorough and ongoing discussion of patient

preferences throughout the hospice stay.

Section Rationale

Seriously ill and dying patients who are allowed to express their preferences regarding life-sustaining treatment

are more likely to receive care consistent with their values, improving patient and family outcomes, including

greater satisfaction with care.

• Patients may come into hospice with documentation of preferences for life-sustaining treatment.

However, pre-existing documentation may not reflect their current preferences because patient

preferences may change, particularly as their condition changes.

• Care for spiritual needs is a critical element of quality of life at the end-of-life.

Patients and/or caregivers should be allowed to express their needs for spiritual care to help ensure their needs

are met.

• One of the unique aspects of hospice care is its interdisciplinary approach to meeting the physical,

psychosocial, and spiritual needs of the patient and caregiver(s). Discussing spiritual concerns is the core

of a rigorous assessment of spiritual care needs and is essential to assuring these needs are met.

Items in this section are intended to capture the process of eliciting patient preferences; they are intended to

capture evidence of discussion and/or communication about patient preferences.

• Orders alone, without evidence of discussion or involvement from the patient/responsible party, are not

sufficient to code “Yes” for these preference items.