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When Is It Time for Hospice?

By Heather Millar

man thinking

I’ve written several posts—here, here and here—about a beloved family friend who is dying of metastatic lung cancer. My throat catches as I write that word, “dying.” Up till now, I’ve written around it: Our friend “has metastatic lung cancer” or simply, “has advanced cancer.”

Not that our friend minces words. He’s been joking for months about “when I check out.”

Now, though, he and his partner have come to a crossroads: Is it time to call in hospice? Is it too early? How will hospice change things? He has already decided to stop chemo and radiation. Why be miserable if it’s not going to change the eventual outcome? But somehow, for them and for many of us, the word “hospice” gives pause.

I think there’s something in the American psyche that equates “hospice” with “giving up.” While the use of hospice has been steadily growing for the last several decades, a 2012 report points out that half of hospice patients received end-of-life care for less than 20 days.

Nearly a third have hospice for less than a week, according to statistics from the National Hospice and Palliative Care Organization (NHPCO). Many patients receive hospice care for only a day or two or three. That was true of my father. He only had hospice for the last two days of his life. He died nearly 17 years ago, but I still feel sad that I didn’t fight harder to get my mother to see that he needed hospice earlier, much earlier. He’d been fighting metastatic lung cancer for a year, and yet, when it came to the end, some of my family members acted like it was an enormous surprise.

That is such a shame. Hospice doesn’t have to mean leaving your home. You  can have hospice services delivered in your own bedroom. Or, if you prefer, you may want to go to a hospice center outside your home. Either way, the folks who are giving hospice care know how to make the dying comfortable, know how to make that transition as peaceful as possible.

I don’t really believe in a “dignified” death. Not matter how you look at it, death is hardly a party. And yet, I think all of us would be so much better off if we allowed ourselves some time to prepare before the inevitable.

Download this October 2013 overview from the NHPCO, or check out these resources on the WebMD site.

I’m glad our friend is considering hospice when he still has several months. I’m glad he will have care to treat his pain and his distress, to make his last days as good as they can be. Isn’t that what we all would want?

Let us know about your experiences with hospice here.

 

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