Difficult symptoms
Pain, dyspnea, nausea, delirium, anxiety, constipation, wounds, or fatigue remain hard to control.
Palliative care guidelines
Serious illness care is not a single turning point. Use this page to recognize symptom, function, and goals-of-care triggers that may call for palliative support or a hospice evaluation.
Trigger is enough
1+
A serious illness plus one significant need can justify a palliative conversation.
Hospital use
2 in 3 months
Repeated hospitalizations are a common signal that symptoms, goals, or support need review.
Earlier support
Any stage
Palliative support can occur alongside disease-directed treatment; hospice is added when prognosis and goals align.
Referral triggers
When a palliative care conversation belongs in the plan
These signs point to added symptom, decision-making, or family support needs.
Functional decline
The patient is losing independence with daily activities or spending more time in bed or a chair.
Treatment decisions
The patient is weighing high-burden treatment, stopping treatment, or deciding what tradeoffs are acceptable.
Caregiver distress
Family caregivers are overwhelmed, uncertain, or struggling to keep the patient safe.
Frequent transitions
Repeated admissions, ED visits, facility transfers, or discharge failures suggest the care plan needs another layer.
Unclear goals
The team needs a structured conversation about prognosis, priorities, code status, or what matters most.
Hospice transition
When palliative needs may now be hospice needs
Hospice becomes appropriate when the clinical picture supports a six-month prognosis if the illness runs its usual course and the goals of care are comfort-focused.
Disease is advancing
Symptoms, hospitalizations, weight loss, or functional decline continue despite appropriate treatment.
Treatment burden is too high
The patient is no longer benefiting from, tolerating, or choosing disease-directed treatment.
Home support matters most
The patient and family need an interdisciplinary team, medication and equipment support, and 24/7 guidance.
Conversation prompts
Questions that clarify what care should do next
Ask plainly, listen carefully, and connect the plan to the patient's stated priorities.
Goals and tradeoffs
What are you hoping for if time is short?
This question gives the patient permission to name comfort, home, family time, alertness, spiritual needs, or unfinished business.
What would be too much to go through for the chance of more time?
Treatment decisions become clearer when benefits are weighed against hospitalization, side effects, confusion, travel, or loss of independence.
Support needs
Who is carrying the day-to-day care?
Caregiver capacity can determine whether a plan is realistic. Include medication management, toileting, transfers, overnight care, and decision support.
What would make home feel safer this week?
Equipment, medication changes, a hospice evaluation, or a family meeting may prevent the next crisis.
Earlier is kinder
Palliative guidance works best before a crisis
A timely referral gives patients and families more room to understand options, align the plan, and avoid decisions made in panic.
Next step
How to move from concern to action
If you are seeing the triggers above, the next step is a focused conversation and a practical handoff.
Name the change
Tell the patient and family what you are seeing: more symptoms, less strength, more hospital time, or fewer helpful options.
Ask permission
Offer to talk about what support could look like now, including hospice if the clinical picture may fit.
Connect directly
Call or refer to Treasure Coast Hospice so the patient gets clear local guidance without waiting for another crisis.
Need help sorting palliative and hospice timing?
Call Treasure Coast Hospice. We can help clinicians, patients, and families understand whether the next step is education, palliative support, or hospice evaluation.