Why Hospice Care Should Begin Sooner Rather than Later
A Common Misconception
Christopher Gray was a devoted husband who wanted his wife Lily to have the best care available when she was diagnosed with a terminal illness. However she spent all but the last week of her life in significant discomfort while being admitted to and released from the hospital multiple times. When Lily was finally enrolled in hospice care just before she died, she was able to remain in their home and receive the symptom relief she had needed for months, but there was very little time left for her to enjoy with her family.
Sadly this scenario happens every day in end-of-life care: patients get admitted to hospice just before they die and experience only a few days of comfort care and peaceful time with their loved ones. In fact a recent study[i] from Yale University shows that half of all hospice patients are admitted too late to fully benefit from the care being offered.
Research[ii] suggests that these delayed admissions to hospice occur because both patients and physicians believe that hospice care is only appropriate during the last few days of life. In fact patients in the US can be enrolled in hospice for at least the last 6 months of life and entering hospice care earlier rather than later in the course of illness has many advantages.
[ii] Vig, Elizabeth K et al. “Why don’t patients enroll in hospice? Can we do anything about it?.” Journal of general internal medicine vol. 25,10 (2010): 1009-19. doi:10.1007/s11606-010-1423-9
Benefits of Early Hospice Admission
The evidence is quite strong that earlier enrollment in hospice is far more beneficial to patients and their loved ones than a last minute admission in a state of crisis. But early hospice care is only possible when patients, caregivers and providers are aware of the benefits and make it a priority. It’s important to plan ahead for these difficult decisions, document preferences in writing, and have conversations about the best care we can imagine for the end of life.
[iv] Tabler, Jennifer et al. “Missed Opportunity: Hospice Care and the Family.” Journal of social work in end-of-life & palliative care vol. 11,3-4 (2015): 224-43. doi:10.1080/15524256.2015.1108896
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