How long does the patient have? It’s probably the hardest question for the hospice team to answer.  Patients and families have different motives for asking.  Sometimes it’s as simple as needing to know how much time to ask off from work, or when to schedule FMLA.  The motive for asking the “time question” might be more complicated, related to caregiver fatigue, expenses, or family dynamics.  Hospice professionals should provide the best answer they can, but every death is a little different.  Regardless of what reason someone has for asking how long a patient has, end of life professionals should respond without judgment.  While the hospice nurse, nurse practitioner, or physician will provide a clinical answer, the hospice social worker and spiritual counselor (also known as a chaplain) can help support the patient and family.  The social worker and chaplain can help to facilitate family conferences and discussions about managing the time the patient has left.  One of the most valuable things a caregiver can do is to listen to what their loved one’s body is saying.  Changes in sleep patterns, food and fluid intake, and social interaction are big indicators for disease trajectory.  When a person begins to actively die, there are milestone changes that can often be seen - changes in breathing, skin color and temperature, and level of responsiveness.  We know your hospice journey is 24/7. You can always connect with us at theheartofhospice.com.  Send an email to Helen and Jerry at host@theheartofhospice.com.  We’re glad to connect with you to support your end of life journey.  You are The Heart of Hospice.