by Jason P. Smith
According to a recent study by the Harvard Women’s Health Watch, more patients could benefit from hospice care if only their doctors would prescribe it sooner.
The hospice philosophy of end-of-life care emphasizes the right to die with dignity and without pain. The role of hospice is to provide care to the dying and support for their families and caregivers.
The new study shows that hospice care is underused, however, often because doctors don’t suggest hospice to patients or delay referring them until shortly before death.
The September issue of the Harvard Women’s Health Watch highlighted a study that shows doctors are slow to recommend hospice care to their patients.
The study also points out that learning about hospice before it’s too late can be particularly important for women, who often shoulder most of the burden of caregiving. The study showed that physicians may delay bringing up hospice for a number of reasons.
For one, doctors are committed to conquering disease, so referring a patient to hospice can seem like a sign of medical failure on their part. Many physicians said they didn’t want to take away a patient’s hope.
Physicians may also fear losing contact with their patients, not realizing that they can and should be a part of the hospice team.
Pat Archer, RN, BSN, MA, director of Exempla Lutheran Hospice, agrees with the study’s findings.
"Education about the value of hospice remains a priority for all hospice providers," Archer said. "We all see the benefit of the ‘earlier vs the later’ referral to this level of care provision. The earlier referral benefits not only the patient, but the family and the physician as well.
"The challenge remains for us in hospice to provide to the public, including the health care professionals, the message that allays the fear of abandonment and focuses on the right care at the right time in the right setting."
Doctors and hospice experts agree that most terminally ill patients benefit from being in hospice for at least three months before death. Hospice is not always easy for patients or doctors and no one should feel compelled to choose between care that extends life and care that provides comfort, says the Harvard Women’s Health Watch study.
"Our duty as physicians is to help our patients discover what’s good for them, and one way we can do that is by providing information about hospice care. If your doctor doesn’t start the discussion, consider starting it yourself," wrote Dr. Celeste Robb-Nicholson, editor in chief of the Harvard Women’s Health Watch.
"Hospice is not the elimination of care," Archer said. "It is the provision of the appropriate blend of care at the time that it is needed most."