Compassionate, informed advice about healthcare decision making

Archive for August, 2013

No Downside to Entering Hospice

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I know it is hard. Symbolically, it is huge. Emotionally it is tough … that is … entering a hospice program.

By definition, going into hospice means, in the physician’s estimate, the patient is within six months of dying. Practically speaking, with the median length of time in hospice under 20 days, it could be much less than the six months.

I can understand people not wanting to go into hospice

I can understand people not wanting to go into hospice. “Hospice means I am dying. I don’t want to die. Therefore, I will not go into hospice. Therefore, I will not die.”

I am writing about this because of a friend of mine who has just signed up for hospice. He has been battling cancer for years. The burdens of living are getting harder but he still lives at home with his wife.

He wrote this recently about enrolling in hospice:

“I am signed up with Hospice. The more we found out about their services, the more helpful it seemed to be for us. It will provide important backup, so we don’t have to run to the ER on a Friday night and wait for six hours, as we did recently with an infected lesion on my neck. If the Hospice nurse cannot help us on the phone, a nurse will come out, even in the middle of the night. We have had three visits in the last two days! We are impressed with their promptness and efficiency. My wife is also finding comfort in the backup for her, and a place to answer any of her concerns/questions.

“Hospice has also given me a medication to increase my energy and one to help with my cough.

“The new piece for me is that if I stabilize or improve, I can always leave Hospice, and re-enter later if I need to. I had thought that once you signed up, it was a permanent commitment.”

This is a move that has no downside

I wrote to him:

“This is a move that has no downside,  in my view. If you die in this current course of this illness then you and your wife will have all their wonderful support. If you get better and no longer qualify for hospice care then you will have had their support when you needed it and they can always come back.”

I thought it was interesting that he did not know you can leave a hospice program and come back in. This way he can still have hope for improvement but if things do not get better he will have all that support, hopefully for months.

There is no downside to hospice.

Hank

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