Chester County Medicine Winter 2020 - 28

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HOSPICE

(and when its ok to eat Pumpkin PIE)
BY: ALAN HENDERSON
ASANA HOSPICE & PALLIATIVE CARE

November 2019
1982 was 37 years ago. Gas was selling for 91
cents per gallon then, the average price of a new
car was $8,000, Michael Jackson's "Thriller" was
released and "Late Night with David Letterman"
debuted on NBC. All these things seem so very
long ago now. But one item that remains "new"
(sort of) took root in 1982 - The Hospice
Medicare Benefit.
Having been given permanent Medicare
benefit status by Congress in 1986, Hospice
remains a modality of healthcare largely misunderstood and (worse
yet) underused by medical professionals and the general public
alike. Hospice may just be the single greatest misunderstood topic
in healthcare. I suppose that, if you ask 10 different people to
offer their definition of hospice, you're likely to come away with
9 different answers. Probably because the notion of anything
concerning end-of-life seems depressing. For most people, Hospice
ranks right down there with filling out Advance Directives or
shopping for gravesites. Not exactly a "picker-upper" topic for
Holiday Dinner discussion. The end-of-life part notwithstanding,
Hospice has gotten a bad rep for no real reason. On the contrary,
modern hospice has more to do with the Quality of Life (QOL)
than anything else. Quality of Life for the patient themselves as
well as the family or anyone the patient designates as family. It's all
about keeping the unit of care (patient and family) as comfortable
(both physically and mentally) as possible. So, truth to tell, we
could all use a little more good information about the "H" word.

28 CHESTER COUNT Y Medicine | WINTER 2020

Before I get into the benefits of hospice, let's look at a
few of the illusions surrounding hospice. Such as...

Hospice is a place where people go to die.
Not at all. I can't imagine anyone wanting to
go anywhere where their demise was the specific
objective. Hospice is not a place, but a philosophy
of holistic healthcare designed to improve Quality
of Life for those people suffering from any terminal
disease.

Hospice hastens death.
Simply because most hospice patients do pass
away while in hospice care, is no proof that hospice quickens the
dying process. In fact, many patients at end of life who employ
hospice care may realize a longer life than those who decide against
hospice services.

Hospice is only available in the very last days or
weeks of life.
That's almost like saying pumpkin pie can only be served on
Thanksgiving. The hospice care model allows for many diverse
disciplines to collaborate and design a hospice Plan of Care.
Central to this design is the patient and family themselves. Not just
to establish a medical protocol for the patient, but to address all
the psychological and social issues this unit of care may be facing.
Therefore, the earlier a patient is admitted to hospice the more
effective the entire hospice care team of medical and psycho/social
professionals can be in providing a quality service.
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Chester County Medicine Winter 2020

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