Late Referrals to Hospice and Care Needs

The proposed issue is the patients being referred late to the hospice, while the solution would be to keep screening patients at risk and repeating a conversation about a needed treatment before it is late. The findings and studies show that late referred patients are struggling more, and the facilities are very limited with the care they are able to provide sufficiently. The cultural assessment of the late referrals is also quite unpleasant, the earlier patient receives effective medical care, the better. Late referrals lead to unmet healthcare expectations and other supportive services, such as social.


  1. Strengthening medical care solutions. It is necessary to provide uniform high-quality care regardless of admittance time, which is a presently unaddressed problem. Later admitted patients tend to receive heavier medication, while some symptoms could never be removed.
  2. Soften the hospice experience. Patients admitted earlier tend to be more sociable, react positively to lighter medication, reducing the cost. It makes the experience easier for the patients and for their families.
  3. Reducing the burden on a caregiver in the family. At some point, the family member can experience the burnout from taking care. Psychologically, it would be easier for the family to admit the patient to the hospice.

Social Justice and Autonomy

For both patient and their caregiver, it is justice to let the patient be admitted to the hospice earlier. It is necessary to ensure that each individual is able to access care at a speed they require to ensure successful treatment, and recovery. Avoiding or remedying late admissions helps patients to be treated at a pace that minimally interferes with their life outside of the hospital, promoting autonomy. Some caregivers argue that it is better to keep the patient home as long as it is possible, but international guidelines strongly recommend patients go into hospice care early to prevent the decreasing psychological and physical symptoms (West et al., 2018). It may be hard for the family to let go the patient after taking care of them, but through a conversation, they may understand that is the best choice.

Further discussing autonomy, there are a number of considerations for promoting it in a hospice. One’s ability to make choices and lead their life is inalienable, and must be protected. If the family waits for too long to admit the patient, they might not be able to make their own decision. Social justice in hospice is giving the greatest amount of care possible, therefore, early admission to the facility is needed, together with the patient’s deliberate decisions along the way. Justice for a diverse population in the hospice is archived by providing the same number of services and care. Nurses should understand the difference in beliefs and attitudes.


West, T. D., Galicia-Castillo, M. C., Cadieux, C. P., & Parks-Savage, A. (2018). Hospice care needs study. American Journal of Medical Quality, 33(4), 443-445.

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1. NursingBird. "Late Referrals to Hospice and Care Needs." April 4, 2023.


NursingBird. "Late Referrals to Hospice and Care Needs." April 4, 2023.