Hospice care, and why I advocate strongly for it

Many people think hospice care is the time at the very end of someone’s life, maybe the last few days when the treatment is just comfort measures, the family is gathered around the dying person’s bed crying with Ave Maria playing, and everyone is just waiting for their person to die.

This could not be further from the case. Entry into hospice care has two requirements: that the person with the terminal diagnosis is deemed to be in their last six months of life by a doctor, and that they cease all curative measures. For the patient, this can be a huge relief because it means the end of chemotherapy, radiation, scans, infusions, clinical trials, hospital stays-- everything but comfort measures and palliative care. Often it’s a time of some recovery and increased quality of life as the side effects from other treatments subside and the running around of deep medical times slides into the rearview. Sometimes a patient can be well enough to travel to see friends or family, or even take those dream vacations in these last months.

Getting a doctor to commit to a timeline like this can be sticky, and many doctors are afraid to scare patients by talking about their prognosis-I am here to advocate strongly for you to ask your doctor regularly what your prognosis is. It may come as a surprise to you that very few doctors are comfortable talking about death. They’ve been trained to keep bodies alive at almost any cost through their entire career, and often feel like failures themselves when a person is facing the end of their life. I know, I know. But doctors are just people and are filled with the same range of human emotions as the rest of us. They are not fortune tellers and are often wrong in either direction with the prognosticating; It’s worth it to keep asking for it. I heartily believe it will help you with your quality of life if you are able to push for numbers and therefore be better prepared to manage the time you do have left. A death doula can help patients organize themselves to ask for hospice care and advocate for the prognosis in support of the patient’s quality of life.