why hospice patients live longer

Friday, November 05, 2004

Why Hospice Patients Live Longer

I mentioned in an earlier post that I was somewhat surprised when this study showed that hospice patients, on average, live longer than those with the same diagnosis who do not elect hospice care. I do not dispute the findings, and, to be honest, am a bit ashamed that I was surprised by the findings.

I, along with most everyone in the medical community I’d guess, have assumed that patients who accept hospice care probably live marginally shorter lives than those who seek aggressive treatment for as long as possible. I have believed for a long time that those who have no hope of finding a cure will live a better life under hospice care than “fighting” to the bitter end, and justify my life by knowing that helping people make the most of their final days is a good thing. If their lives are shorter than those who fight on without hope, thus is the trade off. Right?

Again, I’m a bit ashamed that a study had to come out before I realized what I already knew. In general hospice adds days to patient’s lives. No, this isn’t true for every patient. Of course, this will never be a marketing point for hospice, since the finding goes somewhat against the whole theory of hospice. In the end, it’s true. Let me tell you the two reasons why.

First, hospice can prolong life because hospice patients are surrounded by people who care about/for them. I’ll explain this through an example. I had a patient during my days as a Chaplain that was on her third round with our company. She lived in a drab nursing home and had no family in the state thus had no visitors. When she was referred to hospice she was not eating or drinking anything, had recurring infections, and was no doubt going to die unless something changed. Something changed. Upon being admitted to hospice she started having “visitors” almost every day. The nurses, aides, psychosocial staff, and a volunteer visited regularly and seemed happy to be there. Soon the patient looked forward to the visits, the nurse started bringing her beloved Dr. Pepper at each visit, and the patient found a reason to live. She was eating, drinking, and a much happier person. Her health turned around so much that she was eventually discharged from hospice because she was too healthy. As I said, she was on her third round in this pattern when I met her. I moved on from that company, so I don’t know how the story ends, but when I left she was moving more toward discharge due to good health than she was toward death. The moral of the story: Hospice can extend life because of the compassionate care offered to many who are tired, lonely and ready to give up.

Second, and more often, people live longer on hospice because they get good medical care. This is very true for stroke and dementia patients. Most patients with these specific diagnosis die from complications of their illness. Often, this is an infection that is not caught early enough because the person caring for them, often their family, doesn’t know what they should be looking for. These types of things are often caught by the hospice nurse and treated before they become life threatening. Hospice patients are less likely to die from something that shouldn’t kill them. I know that sound simplistic, but it’s true.

Both of these things boil down to one common point. Hospice patients live longer because they have someone caring for them. Simple, but true.



Nurse Mia

And what a great reminder that palliative care should be provided to all, regardless of health status – good pain management, compassion, and yes, care. I think our general medical system has a lot to learn from hospices. But I am especially glad that hospices exist to provide dignity for those at the end of life.

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