A recent study published in the Journal of Clinical Oncology found that despite all the attention to better end-of-life-care and death with dignity, a majority of people who receive life-extending care in the last week of their life had previously expressed their desire to receive only symptom relief and comfort care. The study also found that these "life-extending" measures did not result in any extension of life.
Here are some other findings from the study:
The end-of-life issues presented in the Journal of Clinical Oncology study are exactly the issues that hospice care tries to address. Hospice is not a new concept. It comes from the word "hospitality." The term "hospice" was first used to describe end-of-life care by Dame Cicely Saunders, a physician who founded St. Christopher's Hospice in London, the first modern hospice care program.
"The patients with the best quality of life and the lowest distress in their last week were those who wished for symptom-directed care and did not receive life-extending measures at the end-of-life." —Journal of Clinical Oncology
In the early 1970s, Dr. Elisabeth Kubler-Ross, author of the best-selling book On Death and Dying, helped introduce the term "death with dignity" to America. In 1974 the first attempt to provide federal funding for hospice care was defeated, but in 1982 Congress included a provision to create a Medicare hospice benefit. Today all American citizens age 65 and older are entitled to hospice coverage through Medicare and hospice is also covered by Medicaid and most private insurance companies.
There are now over 3,000 hospice programs around the country, but hospice is not a place; it is a philosophy of care. The hospice goal is to offer comfort and compassion when cure is no longer possible. Most hospice care is given in the home, but hospice care may also be available in hospitals, nursing homes, or private hospice care facilities. Here are the basic requirements to qualify for hospice care:
The promise of hospice care is to provide a patient with pain control, comfort and dignity at the end of life. There is no attempt to hasten death, nor is there an attempt to extend life. The focus is on providing as much quality as possible, hopefully surrounded by friends and family in a supporting environment. Here is what else you can expect:
If you are caring for someone who may benefit from hospice care, the time to start talking about it is now. Studies show that most patients still do not talk about these issues with their doctors and that hospice care is often started too late for patients to take advantage of all the benefits. Here’s how to begin: