Most adult children rehearse this conversation for weeks and then handle it badly, because they open with the word hospice. Try opening somewhere else.
Start with them, not with the service
Ask what they are finding hardest right now. Ask what a good day looks like, and what gets in the way of one. People will tell you a great deal if the question is about their life rather than about their prognosis.
Nobody argues with being made more comfortable. They argue with being written off.
Name the goal, not the label
“I want you to be comfortable, and I want you at home” is a proposal almost nobody refuses. “I think it's time for hospice” is a verdict, and it invites an argument. The first sentence gets you to the same place with less damage.
Let them say the hard thing
Often the parent has already worked it out and has been protecting everyone else from it. Silence is useful here. If they say they are tired of the hospital, do not rush to reassure them out of it.
Take the fear off the table
Three fears come up almost every time, and all three have straightforward answers:
- “I'll lose my doctor.” They will not. Their physician stays involved and approves the plan of care.
- “It means I've got days.” It does not. The benefit is written for six months and renews.
- “I can't change my mind.” They can, at any time, for any reason.
Include the person doing the caring
If a sibling or a spouse has been carrying this alone, say so out loud, and let them say what they need. Decisions made without them tend not to hold.
You are allowed to get help with this
A hospice social worker will sit with a family and help this conversation happen. That is part of the job, not an imposition on it. Call and ask, even if the conversation has not happened yet.