by Stan Bradley, M.D., Washington Regional Hospice Medical Director
Myth #1: Hospice and palliative care mean that I am giving up.
According to this myth, when you sign on for hospice care you sign away your rights to just about everything--medical treatment, your personal physician, your ability to make decisions. Some may believe that palliative care allows only for a morphine drip.
Reality: Nothing could be further from the truth.
The focus of hospice and palliative care is quality of life. We intend for the patient to get the most out of the time he or she has. Many treatments are available through hospice. In the last year, we had a patient on our service who had a painful mass growing in the side of her neck. The mass was exerting pressure on the nerves of her arm, and her arm got very weak. We arranged for the patient to have radiation treatments for palliative purposes. She completely regained the use of her arm, which made a tremendous difference in her quality of life. Medicare regulations require that a hospice provide physical therapy services when needed. We always try to balance the need for pain relief with the patient's desire for alertness and being engaged with family.
A recent study published in The New England Journal of Medicine showed that early palliative care improves quality of life and may actually lead to longer survival. The patients receiving palliative care had less depression, less anxiety, and survived on average about three months longer than the control population. This study is a powerful rebuttal to the misconception that choosing hospice and palliative care is giving up.
Myth #2: My family and my doctor will know what I want when the time comes.
This is a common myth that people use to avoid one of life's most difficult--and most important--conversations: what to do at the end of life, particularly when you are no longer able to speak for yourself. (This myth can take many forms, including: Talking about death will make it happen.)
Reality: Unfortunately, in today's fragmented healthcare system these conversations do not occur often enough. Most of us don't like to talk about these things, and it takes courage to address these issues with our loved ones. Several studies have shown benefits to surviving loved ones when a person has addressed these matters prior to a time of crisis. A living will or assignment of a healthcare proxy can be helpful, but even more helpful are discussions of our wishes with our loved ones. One way we show love and respect for our loved ones is to follow their expressed wishes in these matters.
Myth #3: If I choose hospice, I'll have to give up my own doctor.
Reality: This is never true. Patients in hospice remain under the care of their own physician or physicians, who work with the patient, family and the hospice team to enhance quality of life and ensure that the patient is as comfortable as possible, day in and day out. Our hospice team consists of a board-certified hospice and palliative care physician, nurses, aides, social workers, chaplains and volunteers. We make efforts to keep the patient's regular physician informed of the patient's progress. We encourage the patient's regular physician to participate in the care.
Myth #4: Hospice is a place.
Reality: Hospice is a model of care delivered primarily in the patient's home, operating under the belief that people would prefer to die as they lived. Sometimes, the care is delivered at a hospice home, the hospital, a nursing home or other special environment. Although more than 90 percent of Washington Regional's hospice care is provided in patients' homes, our Willard Walker Hospice Home is designed for patients who need more skilled care than family or other caregivers can provide at home.
Myth #5: Hospice is only for people with cancer.
Reality: Hospice is available for patients with any condition their physician believes will claim life within six months. Our patients include those with illnesses such as cancer, congestive heart failure, emphysema, end stage dementia and AIDS. People who have Medicare are entitled to hospice care if they seek it. Most insurances have a hospice benefit. We accept all patients regardless of ability to pay.
Hospice is a philosophy as well as a model of care, a paradigm and perspective in caring for patients, patients' families and the greater community as a whole. I know I speak for our entire team when I say it is an honor to serve the patients and families of our community.
Thanks to Jeanne Dennis of the Huffington Post for introducing the concept of the 5 most common Hospice myths.