Show #386 Airing Sunday 5/6/07
Hospice is a difficult topic to talk about. But lack of discussion can lead to a lack of understanding about what hospice can offer us. Here to help us jump-start a conversation about end of life issues is William Lewis, neighborhood services coordinator of the Hospice & Palliative Care Partners of Ohio.
Question: Are people reluctant to use hospice care?
Answer: Yes. Of the 2.4 million Americans who die each year, only a million-less than half-use end of life care. And the average length these individuals used hospice care was only 16 days. So people are not fully using all of the services available through hospice-they don't accept care until too late in the disease process to receive many of the benefits you can from end of life care.
Question: Why this reluctance?
Answer: Culturally, we are a society that wants to "fix things," so the idea of hospice may sound like "giving up" to some. Many people are in denial that a disease is terminal, or are angry and bargaining. Acceptance comes far down the road. And this isn't only for hospice. You see the same reluctance when it comes to prepaying funerals, signing advance directives, etc.
Besides these cultural issues, there are many myths and misconceptions surrounding hospice that we are in the industry often hear.
Question: And today we're going to debunk some of these myths. The first myth is hospice care is inadequate care.
Answer: Some think that with hospice all care is pulled away and we simply allow the person to die. This is not true. Rather, hospice accepts that there is no cure, so the goal switches from curative care to a more holistic care-treatment of symptoms and pain, a long with help fulfilling goals. Maybe the patient wants to go on vacation, go to a wedding or graduation, or mend a relationship. Hospice care can go beyond physical care to psychological, emotional, and spiritual care.
Question: So all medications will not be taken away?
Answer: No. Some may be-we are accepting that the patient is terminally ill so some medication may not make sense. But medications that improve comfort will not be stopped.
In addition, medication for other conditions is sometimes taken. Perhaps the patient develops a urinary tract infection. Antibiotics will be offered.
Question: Can you keep your own doctor?
Answer: You do not have to lose your relationship with your attending physician. We keep the person's doctor in the loop as much as possible. And this is for the patient's comfort as well — they want to be treated by someone they know.
Question: Here's another myth: Hospice care must be received in a specific physical place. like a hospice care center, a hospital, or a nursing home.
Answer: That's also not true. Hospice care can be delivered anywhere. 70% of the people we serve are at home, which is what most people prefer.
Question: Another common belief: You must have a DNR to be on hospice.
Answer: Signing a Do Not Resuscitate order is not mandatory to enroll in hospice.
Question: One last misconception: Once you start on hospice, you must stay on hospice.
Answer: Not true. If you change your mind at a later date, you can elect to come off hospice.
Hospice care can offer so much support. To learn more, give the Hospice & Palliative Care Partners of Ohio a call. The number's next. My thanks to William Lewis.
