“I’m not ready for hospice!”
This is the most common sentence we hear when educating the community about hospice care. There is a prevailing myth about hospice that it is merely for the “last days” of a person’s life and a common question is “When is hospice care needed?” Unfortunately, this myth deters many people from receiving the services that would have greatly enhanced their quality of life, and according to new evidence, may also have extended their quantity of life.
Hospice Enhances the Quality of Life
Most people do not question that hospice enhances quality of life. The care is extremely comprehensive and provided in the comfort of the patient’s home. The goal of the hospice team is to ensure that both the patient and the family achieve and maintain comfort, including physical, emotional, and spiritual comfort. The hospice team provides extensive training to the family on caregiving, safety, and pain and symptom control. The hospice nurse acts as a liaison between the physician and the patient, which results in overall better maintenance of the patient’s healthcare. All of these services combined yield a more confident caregiver and comfortable patient.
Hospice Is Not Giving Up
But when it comes to end of life, many people want to receive more days, not just more quality of days. We often hear patients say they are not ready to “give up.” But hospice is not giving up. It is the continuation of the healthcare we have received throughout our lives. And now, we are finding that hospice can actually give us more days. In March, 2007, an article was published in the Journal of Pain and Symptom Management that reported that people under the care of hospice lived an average of 29 days longer than people not under the care of hospice. A total of 4,493 people with terminal illnesses were selected, and the difference in the survival rates were analyzed (Connor et al.).
What The Study Revealed…
“The largest difference in survival between the hospice and non-hospice cohorts was observed in CHF [congestive heart failure] patients where the mean survival period jumped from 321 days to 402 days. The mean survival period also was significantly longer for the hospice patients with lung cancer (39 days [longer]) and pancreatic cancer (21 days [longer]), while marginally significant for colon cancer (33 days [longer])” (“New Research”, 2007).
Start Your Research Early
So when is the time to call hospice? I always recommend that people begin researching the hospice providers in their area before hospice is actually needed. All Medicare-certified hospices provide the same basic hospice services, but each one is a little different. It is important to do research and interview hospices to ensure that you are receiving care from the hospice provider that is best suited to meet the needs of your family. Hospice can be most beneficial when the prognosis (life expectancy) is six months to a year. In many cases, it is difficult for physicians to provide a patient with a prognosis; it is often best to ask for a hospice evaluation, or at minimum, a hospice education visit, at the time of a diagnosis of a life-threatening illness (cardiac disease, pulmonary disease, cancer, dementia, renal disease, etc.).
Hospice Is About Living
Hospice is about living, not dying. It is difficult to embrace a full quality of life when making frequent trips in and out of the hospital. It is difficult to enjoy the love of family and friends when experiencing pain or other symptoms. Hospice is a healthcare benefit that provides comfort to the patient and family and assists the family in providing care that keeps the patient at home, surrounded by his/her loved ones, pets, and other personal things. Hospice helps maximize not only the quality of days, but also the quantity of days.
h5. Notes: Connor, S.R., Pyenson, B., Fitch, K., Spence, C., & Iwasaki, K. (2007). Comparing Hospice and Nonhospice
Patient Survival Among Patients Who Die Within a Three Year Window. Journal of Pain and Symptom Management, 33(3), 238-246. New Research Finds Patients Do Live Longer Under Hospice Care. (March 21, 2007). Retrieved December
27, 2007, from http://www.nhpco.org/i4a/pages/Index.cfm?pageID=5145.
