Top Hospice Diagnoses & Care Plans


AMOREM’s Service Podcast serves the mission to provide quality, thoughtful, loving care to patients and support to their families and to offer education and grief support to communities served. This podcast is intended to transform the way that people view and experience serious illness and end-of-life.

In episode five of AMOREM’s Service Podcast, Top Hospice Diagnoses and Care Plans, Vice President of the Burke County Service Area, Laura Anderson, guides a conversation about the top hospice diagnosis nationally and some of the common plans of care offered by AMOREM to provide support to patients and their families. Anderson breaks down each diagnosis and explores how AMOREM services can assist with the unique needs of each patient and family.

Anderson stresses that before entering the conversation, it is important to note that when you think about the top hospice diagnosis, everyone’s experience with serious illness can vary.

Within AMOREM’s 12-county service area, cancer is the top diagnosis for hospice care. Cancer is followed by cardiovascular diseases which may include things like congestive heart failure and coronary artery disease. There is also a large population of patients living with Alzheimer’s and dementia.

Because of the industrial nature of AMOREM’s service area, many individuals have served in factories over the course of years which has resulted in a large population of people living with respiratory diseases. Some of these include COPD and pulmonary fibrosis.

Anderson provides that the true beauty in hospice care is driven by the fact that the patient and their family always come first and that they are the ones who are truly driving the care that AMOREM provides. As providers, AMOREM has the opportunity to help patients and families meet their goals, which are often things that many of us take for granted.

To provide comprehensive care, AMOREM teams consist of several individuals and medical providers, all of whom are hospice-trained. Any other provider that the family has had within the community, whether that be a primary care provider or a specialist, will stay involved in the plan of care. AMOREM nurses, social workers, chaplains, certified nursing assistants and volunteers work together to determine the most compassionate and innovative way to meet the goals of each patient and family.

Anderson breaks down how AMOREM teams, a patient and their family establish a care plan. First, the Access and Enrollment team from AMOREM will meet with a family and discuss the services available to the patient and family. Anderson explains that mostly when this initial conversation is had, a patient and their family are familiar with curative care and conversations about how to ‘get better’. When AMOREM comes in, they can ask what a patient’s expectations of them are and what a patient needs from them. The goal revolves around where the patient and family see themselves and what their personal goals are.

Anderson also informs that these ‘top hospice diagnoses’ are not the only illnesses that make an individual eligible for AMOREM services. She explains that many conditions could qualify someone for hospice services or other services provided by AMOREM. Essentially, any illness or condition that may result in a prognosis of 6 months or fewer. However, Anderson does add that many individuals feel as if a physician needs to tell them when that is. She stresses that patients have the right to express their own medical wishes.

To clarify the understanding of pain management and symptom control, Anderson explains that each individual's journey will look different. You can have people of similar age with the same terminal diagnoses, and they are going to look very different from one another because everyone has different comorbidities and backgrounds. She explains that the hospice care team truly must meet each individual where they are to develop an ongoing plan of care.

Morphine is often associated with hospice care and pain management. Anderson says that the reason morphine is a good drug of choice is because it can be administered in several different forms and fashions. It can be given under the tongue or in the cheek if someone is unable to swallow and it doesn’t have a ceiling dose, so it can be increased as much as the patient needs.

Despite common misunderstandings, hospice care providers do not jump straight to morphine. Anderson explains that it is a strong medication, and it is not always the first drug of choice for a patient’s care plan. Medications such as Tylenol or tramadol are also utilized. Methadone is another common medication utilized in hospice care because it is highly effective in pain relief. Similarly to morphine, it can be adjusted easily to ensure that the patient is receiving adequate pain control. If a patient has never utilized a pain medication in the past, hospice care teams will not jump straight to morphine or other pain medications.

In terms of symptom management, hospice care teams utilize many different medications. Medications are often administered for symptoms such as anxiety, depression, shortness of breath and agitation. If a patient is unfamiliar with these types of medications, the hospice care team will start the individual at a low dose to see how the patient may tolerate the new medication. In hospice care, a patient has the right to decline any suggested treatment that is offered.

Anderson continues the conversation by breaking down the top hospice diagnoses and a few of the common elements in a patient's care plan with each specific serious illness. To hear more in-depth plans of care for each top diagnosis, forward to 19:29 in the podcast.

For those living with a neurological illness, Anderson stresses the importance of allowing the caregiver of the patient to have personal breaks. AMOREM’s patient care units offer patients the opportunity to stay at the unit for five days each calendar month and receive care from AMOREM teams. These respite stays allow a caregiver to rest and accomplish outstanding tasks in their own lives. Another important component of a neurological patient’s care is education for the staff, family and members of the patient’s care team. Many times, neurological illnesses can have a dramatic effect on a patient’s mood or behavior, so, all members of the care team need to have the proper education on how to redirect a patient that may be experiencing anger, anxiety or agitation. Anderson adds that it is common to prescribe medication for a patient’s anxiety or agitation even if the family and patient choose not to use that medication consistently. It is good to have on hand in times that a patient may experience anxiety or agitation and will allow the patient and family to reconnect in more of a family-centered way.

In terms of cardiovascular illnesses, Anderson says that trouble breathing, swelling or edema and chest pain come to mind. Some of the solutions could be medication, oxygen and bringing in a hospital bed so the patient can comfortably position themselves, making it easier to breathe or to reduce swelling in their feet. Sometimes, bringing equipment into the home can be one of the most important pieces of a care plan. That equipment is paid for through the Medicare Hospice Benefit and is at no cost to a family or patient in most cases.

When you think of cancer, symptom management and pain control measures usually depend on the location of the cancer in the body. Someone living with brain cancer will most likely require different interventions than someone experiencing liver cancer. Pain is often heavily associated with cancer, whether it be headaches or specific to the actual area where the cancer is. This is something that care teams work to manage to alleviate a patient’s pain. Anderson breaks down several different pain management solutions for various types of cancer that a patient may be living with.

Anderson ends her session by expressing that hospice care is much more than death and morphine- it is all about meeting a patient and family where they are and providing the very best care possible.

AMOREM’s Service Podcast is proudly brought to you by AMOREM, your local, nonprofit, hospice and palliative care provider. AMOREM has provided services to the community for more than 40 years, formerly as Burke Hospice and Palliative Care and Caldwell Hospice and Palliative Care, and has served the High Country for more than 10 years. To learn more or to make a referral, visit or call 828.754.0101 to speak with a local team member.