 | Jerry Old MD is chief consulting medical officer with Hospice Care of Kansas and an associate professor at the University of Kansas School of Medicine-Wichita. He is a nationally recognized author and speaker on end-of-life issues. You may contact Dr. Old by phone at 1-800-HOSPICE. |
Hospice
2011-07-01 08:32:00
Hospice is NOT about death
Answer: There is now scientific evidence in the medical literature that people on hospice care live, on average, longer than their counterparts who choose aggressive care! In one recent study, patients averaged living 29 days longer and rated their quality of life as “superior” to those on aggressive therapies. For example, people with end-stage heart disease lived an average of 81 days longer; for lung cancer it was 39 days longer; and for pancreatic cancer it was 21 days longer.
As a medical director with Hospice Care of Kansas/Hospice Care of the Midwest for the past 10 years, I have seen both physician and public views of hospice change. There is now global awareness that hospice and palliative medicine must be a reliable part of every health care system. We have left behind the era where hospice was timidly advanced as a ‘choice’ or an ‘alternative’ to standard care. More and more people are choosing the option to stay home, to forego expensive (and often painful) medical therapies that don’t help much, to maintain control of their decisions, and have quality of life at home when reaching the end of their physical lives.
So hospice is really about Life—not death! It is about living the best quality of life for as long as one can live it. It’s about the “bucket list” and doing the things that one enjoys. Priorities change and some things seem a lot less important, while other duties and relationships take on a more immediate concern.
The biggest problem is knowing, or admitting, when one is “ready for hospice!” Some people still equate calling hospice with “giving up”. In reality, the hospice philosophy recognizes that approaching end-of-life is not merely a medical event, but a profoundly personal journey. One of the most frequent statements from patients and families is “I wish I had called hospice earlier!”
We now have 21st century technology to keep people alive indefinitely, and many great medical miracles abound. We should embrace those medical miracles that enhance life. But what comes after the miracles—mortality rate is still 100 %. We must not forget the 19th century principles of palliation--putting emphasis on quality of life and treating symptoms, rather than sacrificing everything for a cure. Not realizing these principles is one of the factors that is bringing our country’s health system to a state of economic crisis.
Perhaps our mission should not be as much about adding years to our life, but about adding life to our years. It appears that the gentle, natural philosophy of hospice may help us to do both. As people travel to visit family members during this summer and fall vacation time, it can also be a time to reflect on “quality of life,” and to discuss individual wishes with loved ones and friends.
