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When to Consider Hospice Care

October 10, 2017



People who put off hospice care spend months in and out of hospitals, where families struggle to take care of them after attempts to cure a disease are usually stopped and replaced with treatments for pain and suffering. Many patients near the end of their lives wait too long to enter hospice care, reports a new study published in the Journal of the American Geriatrics Society.


“When folks are referred to hospice only in the last days of their life, it’s difficult to have a meaningful benefit,” says Thomas Michael Gill, M.D., professor of geriatric medicine at Yale University.


Hospice is specifically designed to increase patients’ quality of life toward the end of life. Many of the most debilitating symptoms—pain, nausea, depression, and shortness of breath—decrease substantially only after hospice begin.


Many patients suffer needlessly for months, says Diane Meier, M.D., the director of the Center to Advance Palliative Care and a professor of geriatrics and palliative medicine at The Mount Sinai Hospital. “Remaining in your own home [something hospice makes possible] - a familiar place with familiar people - is safer and offers better quality of life.” In case of people with terminal conditions including frailty, there should be an ongoing discussion with their doctor about their goals and priorities long before hospice is being broached to avoid dubious interventions or unnecessary hospitalization.


Hospice is an end-of-life care where the focus shifts from medical interventions aimed at a cure to palliative care, and includes medical and nursing care, counseling and social services, with a specialized team—working in a patient’s home, a nursing home, or a hospice facility—treats all physical and emotional symptoms that cause distress.


There are two key signs that suggest it might be time to broach the topic for someone nearing the end of life: patient has increasing difficulty taking care of self and struggles with basic tasks such as walking, getting out of a chair, bathing, dressing, and using the toilet; and symptoms such as severe pain, shortness of breath, hopelessness, depression, and profound fatigue are all treatable in hospice.


A patient with terminal cancer, featured in a 2014 Consumer Reports article, called entering a hospice program—nearly nine months before he died—“one of the best things that’s happened to me in the last I don’t know how many years.”



Read full report here:

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