Question: How common is it for a hospice patient to recover, and what care is recommended after?
Answer: This is a great question! There are several dimensions to this, and I’ll walk you through them.
It’s highly unusual for hospice patients to “recover.” The diseases that prompt people to come into hospice in the first place are conditions that by definition are not curable.
However, it’s not uncommon for patients to experience stabilization of their condition. For example, a patient may have experienced a significant stroke from which the medical team does not believe they can recover, so they are admitted to hospice. But they may in fact start to experience some stabilization, even though they remain significantly compromised—and they no longer qualify for hospice services. We see that on occasion with patients who are admitted to the hospice with critical diseases – fractures, trauma, infections, sepsis, etc. – from which they are likely to die. But ultimately, often inexplicably, they don’t.
Similarly, patients with chronic, progressive disease such as Alzheimer’s disease, congestive heart failure, or chronic lung disease may have a trajectory that suggests they won’t survive more than a few months, making them eligible for hospice services. However, with the provision of hospice services and control of problematic symptoms, their trajectory may change—no longer anticipating a short course.
Regulators recognize that conditions may change, and patients once eligible for hospice may no longer have a terminal condition that might qualify them for hospice. We sometimes refer to them as “hospice graduates.” Most hospices fall into a range of 5-15% of their admitted patients who ultimately “graduate” and are discharged from hospice services.
The conversation wouldn’t be complete without mentioning a rare but identified condition referred to as “vanishing cancer syndrome.” This is a circumstance in which a cancer is definitively diagnosed, with no treatments offered, or progression despite treatment. The patient is admitted to hospice, but several months later, the patient has not died and seems to be improving. Further studies demonstrate the cancer is no longer there. Theories ranging from a “super immune” response to a miracle have been proposed, but an explanation for the phenomenon remains elusive. I’ve seen it twice in my career.
As far as aftercare, that would be individualized. It would typically include some aspect of home health services and/or private duty resources, as well as ongoing management by the patient’s primary medical team.