In the hip fracture scenario, which action aligns with the recommended approach when the patient is in hospice and declines transport?

• A. assist the patient to bed.
• B. encourage hospital.
• C. immobilize and transport.
• D. ignore the request.

Answer: (B)

When a patient in hospice with a hip fracture is not seeking transport, the guiding principle is to honor the patient’s goals while ensuring comfort and safety through coordination with the hospice team. Encouraging hospital involvement means discussing options with the patient (and family if present), confirming that the patient understands the consequences, and contacting hospice or the receiving facility to arrange appropriate on-scene comfort measures and analgesia, and to ensure the care plan remains aligned with the patient’s wishes. This approach supports autonomy, avoids unnecessary emergency transport, and ensures that symptom control and appropriate documentation are handled with professional guidance from the hospice team.

Assisting the patient to bed or immobilizing and transporting would push beyond the patient’s stated wishes or safety needs, while ignoring the request or pushing for hospital admission would undermine autonomy and could bypass essential palliative care coordination.