Guest Post: 3 Common Hospice Myths Worth Clarifying

This week, I am honored to host a guest post by Paula Spencer Scott, the Senior Editor at Caring.com, the leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. Paula is a 2011 MetLife Foundation Journalists in Aging fellow and writes extensively about health, caregiving, and hospices.


Hospice care is an underused resource that can make a loved one's waning days more comfortable and less stressful. Unfortunately, misconceptions about hospice abound. As a result, many families avoid it or wind up having less-than-ideal experiences.
Frank conversations about hospice care are useful, whether you're wary about choosing hospice in the first place or you've decided to put a hospice plan in place.

The following three myths come up again and again, hospice providers say. If they strike a chord with you, use them as starting points to clarify what to expect from the experience.

Myth: Hospice is only for the tail end of life. 
When to start hospice? Usually, "earlier than you think," palliative care experts say. Sometimes families, or even doctors, are reluctant to bring up the subject for fear they'll be thought of as "giving up." As a result, their loved ones spend only a few days in hospice care, although it's designed to provide a peaceful end-of-life transition for weeks or months.

The general rule of thumb for admittance to hospice is that a patient is diagnosed with a condition that generally will result in six months or less of life. But nobody has a crystal ball -- and nobody gets kicked out of hospice because they're still alive six months and a day later. Many patients check in and out of hospice programs.

Ask your care provider: What comfort care options your loved one has at the same time you're discussing treatment options, especially if he or she wishes to have a noninvasive death experience at home. It's also possible to pursue both comfort care and curative care at the same time, so ask about that.

Myth: Hospice can't know what my loved one needs as well as his or her doctor. 
Hospice focuses on providing comfort and support, rather than curing an illness. It's a form of specialty care, although the patient's doctor can remain in the loop about care management. Regular medical treatment is not usually front and center, however, because the focus is shifting to allowing the person to live with as much privacy and dignity, and as little pain, as possible.

Hospice services differ by individual need and preferences but may include basic care management (such as chores, meals, personal care), counseling, physical or occupational therapy, caregiver respite, spiritual care, and bereavement support. There's some evidence that people at the end of life live slightly longer when enrolled in hospice than they would if not, possibly because there's less stress from futile invasive therapies.

Ask your care provider: What kind of services he or she recommends, how your loved one's primary doctor plans to interface with the case, how communication will flow between hospice and the medical practice, or whether a hospice doctor will now manage care.

Myth: The medication will "dope up" my loved one. 
Pain medication given as part of palliative care is meant to ease suffering -- not to hasten your love one's decline and demise. Dosages are carefully calibrated to manage pain, which makes it easier for your loved one to talk, rest, or spend time with family and friends. Uncontrolled pain is a common reason for poor quality of life at the end of life.

What's more, pain management is only one part of the full picture of comfort care. Your loved one can receive talk therapy, spiritual counseling, and physical support (even things as basic as help avoiding painful bedsores) that help him or her feel better than he or she might otherwise.

Ask your care provider: What the pain medication is for, how to use it, how to know when it's necessary, and what signs of pain and discomfort to watch for.

For more information about caregiving and hospice, visit Caring.com. Thanks to Paula for joining us at The Doctor is Listening!