Hospice care shifts the medical focus from curative treatment to comfort and quality of life for individuals with a terminal illness. The primary goal is palliative care, involving actively managing symptoms to ensure dignity and peace during the final stage of life. When addressing respiratory issues, administering oxygen is viewed as symptom control rather than life extension. Supplemental oxygen is provided only when it directly contributes to the patient’s physical ease.
Oxygen Use for Symptom Relief
Yes, hospice provides oxygen when it serves as a comfort measure for the patient. Oxygen therapy is a form of palliative treatment aimed at alleviating the distressing sensation of breathlessness, known as dyspnea. The philosophy of hospice care dictates that any intervention improving a patient’s comfort and quality of life is appropriate.
This provision is distinct from oxygen used as a curative treatment, which hospice does not cover because it falls outside comfort-focused goals. For patients experiencing air hunger, supplemental oxygen is administered like any other medication to manage a specific symptom. It is not intended to reverse the underlying disease process or prolong life, but to reduce the distress associated with difficulty breathing.
The relief provided can be psychological as much as physical, as the presence of oxygen may reassure both the patient and the family. Hospice teams typically use low-flow oxygen, often between 2 to 5 liters per minute, delivered via a nasal cannula. If the therapy does not achieve the desired symptom relief, the hospice team explores other comfort measures or adjusts the treatment plan.
Clinical Assessment for Respiratory Distress
The decision to administer oxygen in hospice is based on the patient’s self-report of symptoms, not objective blood oxygen levels. Dyspnea is a subjective experience, and hospice teams prioritize this feeling of shortness of breath over a pulse oximetry reading. Clinicians often use standardized tools, such as a Numerical Rating Scale (NRS) from 0 to 10, to assess discomfort severity.
For many breathless patients who are not significantly hypoxic, supplemental oxygen may not provide additional relief compared to using room air. In these instances, alternative non-pharmacological interventions are often trialed first or used concurrently. Simple measures like adjusting the patient’s positioning or directing a small fan toward the face can effectively relieve dyspnea by stimulating the trigeminal nerve.
If oxygen is prescribed, it is considered a therapeutic trial, and its effectiveness is regularly reviewed based on the patient’s reported comfort score improvement. If oxygen does not reduce the sensation of air hunger or causes discomfort, it may be discontinued or replaced with other pharmacological agents. Opioids, such as morphine, are often a more effective first-line medication for relieving severe dyspnea, even in patients who are hypoxic.
Equipment Logistics and Coverage
Once the need is established, the hospice provider seamlessly manages the practical delivery of oxygen to the patient’s home. The equipment typically includes an oxygen concentrator, an electrical device that filters nitrogen from the air to supply concentrated oxygen. This machine runs continuously to ensure a steady supply for the patient.
For patient mobility and transport outside the home, the hospice also supplies portable oxygen tanks or cylinders. All necessary supplies, such as nasal cannulas and tubing, are delivered and maintained by the hospice team. This ensures the equipment is functioning properly and that the patient and caregivers have a reliable supply.
The Medicare Hospice Benefit includes comprehensive coverage for all necessary medical equipment, including oxygen. The cost of the oxygen equipment, delivery, and related supplies are bundled into the per diem rate paid to the hospice agency. This means the patient and family generally incur no direct, out-of-pocket costs for the oxygen equipment when it is used for symptom management related to the terminal illness.