“Hospice kills!” that appeared on my website under what do you want me to talk about. At first I was surprised but then I realized that yes, some people actually believe that hospice kills. Upon refection I started asking myself why that is a perception? How did we get to the place where people think we kill our patients because they die.
My answer is multifaceted. It is in part because people don’t understand there is a process to dying from disease and old age therefore how a person dies looks awful and scary. It is because end of life care is different than caring for someone who is going to get better that we think the care being provided is causing harm. It is because our medical profession is perceived as fixing people, no matter how sick the person is. Hospice care has then failed, has let the person die when death comes.
We have come to expect and believe that if only more treatment had been given, mom would still be alive. If only narcotics had not be used, mom would still be alive. If only mom had been fed, had been given IV fluids she would still be alive. All these beliefs and thoughts are because most people are uneducated about the dying process. Other people die, I am not going to die and neither is anyone close to me is our thought. We are ostriches with our heads in the sand and then one day we are faced with dying, our own or someone close to us, and we are unprepared.
Yes, hospice kills reflects general ignorance but whose responsibility is it to teach the difference between real life and TV? I’d say it is us, the health care providers, the doctors, nurses and social workers, that are interacting with the patient during their disease process.
It would be ideal if all health care professionals understood the natural dying process. If all understood that death comes to everyone, that there is a time to treat and a time to stop. That there is a time to explain that death cannot be forestalled and here is what happens now. But that isn’t always the case.
When I first read Hospice kills my thought was hospice is not doing their job of educating well enough--and yes, I do feel that is an element here but I also believe as I said earlier that it is not just for us who work in end of life to teach but all medical professionals. If health care across the board recognizes that death is a part of living, that death will come and is not a failure but a normal natural progression, then ALL will teach that hospice helps people LIVE until they are dead. ALL will support the philosophy and recommend hospice care in a timely manner.
Misinformation about narcotics is huge in relation to “hospice kills". Our society today has a lot of fear round drug use, addiction, and overdosing. We see misuse of drugs daily on the news. Most people don’t understand regular, acute pain management and narcotic use, let alone end of life pain management and narcotic use. It is another Blog post to explain end of life pain management BUT I can assure you Hospice personnel are experts in appropriate comfort care.
Another aspect to consider is that from a practical, monetary stand point it makes no sense for a hospice agency to “kill” its patients. Hospice is reimbursed for every day that the patient is alive. The most money spent on a patient is in the first few days and the last few days. It is the space in between where extra monies balance out. Hospices want their patients to live months. That is how the bills are paid.
The word “kill” as defined by the Cambridge English Dictionary is “to cause someone or something to die.” dictionary.cambridge.org/us/dictionary/.../... Cambridge Advanced Learner's Dictionary kill definition, meaning, what is kill: to cause someone or something to die...
Hospice does not cause death. Disease causes death. Hospice does allow death to occur in its normal, natural time frame in the most humane, non suffering manner possible. Hospice does not hasten death but unlike its counterpart (dying in an acute care setting), it doesn’t try to prolong approaching death either.
Something More about Some Think Hospice Kills...
The Final Act of Living, clarifies what hospice does, and doesn't do. I share stories of how I came to be a hospice nurse, what it was like to be a hospice nurse in the early days, and some my profound experiences with certain patients. It paints the picture of all you can expect from hospice.