But… won’t hospice kill Dad?

by Terre Mirsch

“I’m not ready for hospice yet. My neighbor had hospice and she died a day later.”

“The doctor suggested hospice care for my wife but someone told me that they would just pump her full of medications until she dies.”

“Medications, like morphine, hasten the dying process. I’m not going to let Hospice give any pain medications to my Mom.”

“We really need some help caring for Dad, but won’t hospice kill him?”

Sadly, I hear these, and similar, statements often. In fact, one of the greatest barriers to hospice care is the commonly held misconception that hospice hastens the dying process. Some even believe that hospice administers medications with the intent to cause death. This practice is called euthanasia, and is illegal in the United States. It is also in direct conflict with hospice philosophy, which is to help people live each day as fully and comfortably as possible.

But what if I told you that studies have shown that hospice and palliative care may, in fact, prolong life?

One study, reported in the Journal of Pain and Symptom Management in March 2007, found that hospice patients lived an average of 29 days longer than those that did not have hospice care. Increased survival was most significant for those with heart failure, lung cancer, and pancreatic cancer. Another study, published in the New England Journal of Medicine in 2010, found that lung cancer patients who received palliative care in conjunction with standard treatment lived nearly 3 months longer than those who received standard treatment without the benefit of palliative care services. Not only did those that received palliative care live longer, they reported higher quality of life and better symptom control with less pain, less depression, and earlier enrollment in hospice care.

Many people, including health care professionals, were surprised when the results of these studies were published.  I and other hospice and palliative care professionals were not. The studies validated what we already knew: optimal management of pain and other symptoms, additional practical help, and emotional and spiritual support contribute towards better outcomes of care. Medications used in hospice care bring comfort and relief of pain and other symptoms, not an early death. The interdisciplinary team provides guidance and support that empowers those with serious illness and their families. For some, this means an improved life expectancy in addition to improved quality of life. Sometimes, it even means their condition improves such that they no longer need hospice care (we will discuss further at a later time).

As a caregiver, understanding the facts regarding the impact of hospice and palliative care services is critical. Too many people delay choosing hospice care because they are misinformed. In fact, half of those who receive hospice care will receive care for less than 3 weeks. Not because hospice hastened their death, but because they were referred late in their illness or because unfounded fears delayed decision making. Hospice and palliative care do not hasten death. The services may, instead, contribute towards prolonged life when this type of care is chosen before the last days or weeks of life.

Many family members express words of gratitude for the support hospice provided them, stating “We couldn’t have done it without you” or “You were our angels of mercy”. Unfortunately, this is too often followed by “We wish we had utilized it sooner”.