By Toni L. Eaton, RN, BSN, MS, President & CEO of Old Colony Hospice & Palliative Care
When it comes to hospice, everyone should consider the “Presidential Treatment.” Just look at President Jimmy Carter’s experience.
Carter’s hospice care was recently extended beyond six months, underscoring that hospice offers benefits to those who enroll early and that becoming a hospice patient focuses on living life to its fullest rather than dying.
After serving tens of thousands of patients at Old Colony Hospice & Palliative Care and receiving multitudes of emotional thank-you notes over the years, I can tell you this: We never hear from families that they wish their loved ones had started hospice care later. They always say they wish they had learned about hospice earlier.
When Carter entered the hospice program in February, many people assumed the 98-year-old was on his deathbed. Instead of dying, though, he is enjoying his life, and his family reports that he is appreciating time with friends and relatives, staying abreast of the humanitarian works of the Carter Center, and planning his 99th birthday party.
The idea that hospice is only a short-term situation is slowly changing, but the myths and misunderstandings around hospice are very common. Sadly, these misconceptions prevent many people from enjoying the time they have toward the end of their lives.
You may be wondering, “Wait a minute, isn’t hospice for people who are dying soon? How is President Carter still receiving hospice care over six months later?”
Yes, to become eligible for hospice, patients must choose to forgo curative treatments and have a diagnosis of disease or illness that gives them a life expectancy of six months or less. But, having said that, this does not mean that they only have six months to live. In fact, patients who enter hospice care earlier usually live more comfortably and live longer than predicted. We frequently see this with our patients.
If the six-month marker is reached, patients are reevaluated, and if their healthcare providers believe they have a life expectancy of six months or less should their condition run its normal course, their hospice care can be extended, as it has been in Jimmy Carter’s case.
While some hospice care does run only a few weeks or days, the average length of hospice care now runs roughly 90 days, and for many, it is much longer. But more important than the length of service, patients and families report better quality of life when they get earlier care.
The research from NORC at the University of Chicago, published in the spring, found that regardless of how long patients were in hospice, they and their families experienced “increased satisfaction and quality of life, improved pain control, reduced physical and emotional distress, and reduced prolonged grief and other emotional distress.”
Carter’s decision to publicly share his choice to go into hospice early highlights the family’s positive experience of giving them more time to enjoy each other and make more memories. This offers people a chance to see a more modern model of hospice that emphasizes a higher quality of life after a patient decides they do not want to pursue medical treatment.
When Carter decided to enter hospice care, it was after a series of hospitalizations for an undisclosed condition. Many people think of hospice as entering the scene only when there is a precipitous decline in health. But increasingly, many people decide on hospice care after they tire of spending their time in the revolving cycle of hospital stays and instead opt for comfort treatment at home, such as pain management, respiratory therapy, spending time with family, and spiritual care.
This doesn’t mean that patients are giving up. It means they are prioritizing their goals and wishes over treatment, and that often lifts a burden off patients and families. They can concentrate on enjoying their time together. If, at any time, a patient decides they do want to pursue medical treatment, they can unenroll from hospice and do so.
Sadly, many do not explore their hospice options until later, and only about half of all people eligible for hospice are receiving the benefit at all. But as attitudes slowly change, we hope people will take advantage of this kind of care and consider the “Presidential treatment” of electing hospice sooner rather than later.
Toni L. Eaton, RN, BSN, MS, is the President & CEO of Old Colony Hospice & Palliative Care
of West Bridgewater, a dynamic non-profit hospice serving more than 55 communities south of
Boston. OCH also runs the Dr. Ruth McLain Hospice Home in Braintree. A native and resident
of the South Shore, Toni brings her compassion and experience as a nurse, veteran, and
community leader to her insightful columns for South Shore Senior News. She is also the founder
of Sunny Paws Dog Rescue. Several groups have honored her leadership, including the South
Shore Women’s Business Network. She currently sits on the board of the Hospice & Palliative
Care Federation of Massachusetts. For more information, call (781) 341-4145 or visit Old
Colony Hospice & Palliative Care at www.oldcolonyhospice.org.
