Susan LevineNational hospice month in November focuses on quality of life

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November is National Hospice and Palliative Care month – a good time to address some of the myths surrounding a topic that affects everyone.

: Hospice is for the dying.
Fact: Hospice and palliative care are for the living. This philosophy of care focuses on improving quality of life for patients with life-limiting diseases and their families. Comfort comes from medication and nursing care that eases physical symptoms; counseling for social, emotional and spiritual issues, and therapies that enhance well-being, such as massage, music and pet visits.

Myth: People who go on hospice die more quickly than those who don’t.
Fact: Hospice is about comfort, not cure. But sometimes making people comfortable makes them live longer as well as better.

According to an article in the August issue of the New England Journal of Medicine, patients with advanced lung cancer who were given palliative or comfort care early on lived nearly three months longer than those who received standard medical care. Other research also has shown that hospice patients can live longer. In fact, about 10 percent of Hospice of the Valley’s patients “graduate” and go off hospice.

Myth: It makes no difference where you die.
Fact: More than 80 percent of people who die in the United States have a long, progressive illness such as cancer, heart failure or Alzheimer's disease. Though most of them say they want to avoid hospitalization and intensive care when they are dying, that’s not what happens, according to the Dartmouth Atlas Project, which tracks health care trends.

Hospitalizations during the last six months of life are rising: from 1,302 per 1,000 Medicare recipients in 1996 to 1,441 in 2005, Dartmouth reported in June.

Another study, published Sept. 13 in the Journal of Clinical Oncology, found that cancer patients who die at home with hospice services had a better quality of life in their final days compared to similar patients who died in the hospital. Among family caregivers, 21 percent of those whose loved ones died in the hospital developed post-traumatic stress disorder six months later compared to 4 percent of those whose loved ones died at home with hospice.

Myth: Hospice care costs money for the patient and family.
Fact: Hospice care is fully covered by Medicare and nearly all insurance companies. People without insurance and without the ability to pay are served by Hospice of the Valley, a not-for-profit that provided $9 million in charity care last year in Maricopa County.

Myth: Hospice care costs taxpayers more money.
Fact: The cost of care for terminally ill cancer patients who stopped hospice care was nearly five times higher than for patients who stayed with it, according to a recent study by researchers at the Yale School of Public Health in New Haven, Connecticut, and Mount Sinai School of Medicine in New York. Patients who stayed with hospice incurred an average $6,537 in expenses from the time of hospice enrollment to death, while those who stopped hospice care incurred an average $30,848 in expenses. Treating chronic illness in the last two years of life consumes nearly one-third of all Medicare dollars.

Susan Levine is executive director of Hospice of the Valley, a not-for-profit community hospice founded in 1977. Visit, your not-for-profit hospice since 1977.