Hospice: Five Myths

by Richard Frank, MD

There are two words in the English language that most individuals would rather never hear. The first was historically so shrouded in mystery and fear that it was referred to only by its first letter: it was called the "C" word. Now, we all know the C word as cancer and speak freely and openly about it. We have come this far because of famous individuals who dared speak it about themselves in public and because medical advances have led to the widespread understanding that cancer is not necessarily a fatal diagnosis. Overall, statistics show that two-thirds of cancer patients will survive their disease. Still, too many will succumb to cancer because the cures are just not there yet.

When death from cancer or any terminal illness becomes inevitable, then the second "dreaded" word must be uttered: hospice.

I write of hospice this early in my WebMD blog career because it is so important to the care of many cancer patients. When a patient and their physician can no longer effectively keep a cancer in check, they must have a discussion about end-of-life care and hospice. The goal is to make dying as painless, comfortable, peaceful and dignified as possible for all involved.

So why do people avoid talking about hospice or embrace it too late? The top five reasons or myths are listed below:

The Five Myths of Hospice:

  1. Hospice takes away time. In fact the opposite is true, hospice gives time. How? By giving the patient and their loved ones the time to say the things they always wanted to say. According to Ira Byock, MD in his book The Four Things That Matter Most, these include uttering the words: "Please forgive me." "I forgive you." "Thank you." "I love you." By choosing hospice in time, a family can have many weeks, even months of peace without excessive medical interventions, the patient's condition can actually improve, and relationships can heal and deepen.
  2. Hospice means you cannot die at home. In fact, home hospice is a growing movement in America. Medicare and other insurance carriers will pay for home visits by all members of the hospice team, including home health aides, nurses, physical therapists, social workers, bereavement counselors and spiritual advisers/non-denominational chaplains. Hospice does not mean 24/7 care, but the team can help advise how to take care of the patient around the clock; volunteers from the hospice are also often utilized.
  3. Morphine kills people. End-stage cancer and diseases of the liver, kidney or nervous system are what ultimately leads the body to shut down. Morphine helps ease the physical pain of the dying process and provides great comfort. Use it as advised.
  4. Hospice means all hope is lost. No, choosing hospice just changes the focus of hope. From hope to a recovery that is not possible to hope for inner peace, freedom from pain, time with loved ones and even laughter and happiness in recounting special moments in a life.
  5. Hospice is irreversible. If a patient clinically improves on a hospice program and wants to pursue therapy again or if a new advance becomes available that previously was not, the patient can revoke hospice and seek treatment to be paid for by their medical insurer. By the same token, should hospice again be desired once revoked, it is still available.
    Study after study has shown that those who embrace hospice are more at peace than those who never came to terms with the loss of their beloved. No doubt, I have never heard any family regret choosing hospice, but I have heard it said many times that "I wish we chose hospice sooner."

From WebMD

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