When Should Doctors Talk About Hospice?

Why are many doctors hesitant to recommend hospice care? In some cases, they may be uncertain about the kind of response they will receive from the patient and the family. Doctors have told of family members reacting badly when the mere mention of hospice is presented.

In a recent article, University of Pennsylvania Health System doctor David Casarett spoke about that hesitancy, saying, “Physicians don’t want to cause that sort of distress. We’re basically nice people. We don’t want to walk in and start a conversation that will make a person start crying.”

But that hesitancy to address the possibility of hospice care can prevent patients and families from experiencing the full benefits of the care that hospice provides.

In the same article, Dr. Susan Block of the Dana-Farber Cancer Institute in Boston says, “The average time of the first conversation about end-of-life is 33 days before death. That’s really late, when you think about how much people have to come to terms with.”

She continues, “Hospice is the gold standard for end-of-life care for most people. Yet for many patients, that first conversation about hospice is the first time anyone has told them that their disease wasn’t going well.”

Dr. R. Sean Morrison of Mt. Sinai Hospital in New York offers words that doctors can share with patients when talking about hospice. He suggests doctors say something like this: “I wish we had a treatment that could take [your tumor] away, but we don’t. So we need to focus on other treatments that will enable you to have the best quality of life you can have for the longest period of time. That means focusing on pain, avoiding infections, spending more time with your family.”

We acknowledge the fact that talking about end-of-life issues can be just as difficult for doctors as it is for any of us. We encourage doctors, especially those whose patients are dealing with life-threatening conditions, to mention hospice early in the treatment process, so that patients and family members will have a better understanding of what hospice is and what hospice does.

For more information about hospice care, call us at Hope Hospice at 314-984-9800.

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