Monday, April 18, 2005

Hospice Stats

Of the people enrollled in hospice, 30% die within one week of admission. The average period of time before death is 40 days. What does this mean? Does this mean that hospice equals a quick death? No!

It means that people are not being referred to hospice soon enough. Doctors, patients and families don't enroll in hospice until there is very little time left. This is an on-going struggle for both hospice and palliative care services. The more common this occurence is, the more it reinforces the misconceptions about end of life care. It's like a no-win cycle.

Both hospice and palliative care services are about living - and improving quality of life for people who are terminally ill. Hospice is available during the last six months of life. How do you know when you've got 6 months left? Well, no one can say definitively, but there are many indicators. Stay tuned for the post on "prognosis."

Palliative care, on the other hand, is available for anyone with a chronic, progressive disease (a disease from which they cannot be cured and will likely eventually die from) and can and should be initiated at any time from the moment of diagnosis - even if that is ten years before they will likely die. I'm currently working with a team of advanced practice nurses as well as another team of palliative care doctors strategizing how to get patients involved in palliative care earlier in the course of their disease. Palliative care is essentially symptom-management - focusing on quality of life while living with disease. However, more and more, it is being associated, like hospice, with the end of life. I hope to help break that association. We all want to be comfortable and lead a happy life whether or not our health is perfect, right?

Here is another statistic and one that I hope will actually grow. Of those enrolled in hospice, 5% live more than 6 months. Are they being referred to hospice too early in their care or is hospice giving them a higher quality of life that is more worth living for? I don't know. But think about it.

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