Jennifer Y. Sheng, MD
Most patients with cancer fear the word “hospice.” It marks the “end of the road” and is to be avoided at all costs. Because of this misconception, which also affects physicians, many patients with cancer use excess hospital care and intensive care services at the end of life. Acute hospitalization accounts for nearly half of Medicare spending for patients with advanced cancer.1
Introduced in the United States more than 40 years ago and added as a Medicare entitlement in 1982, hospice is the model for compassionate care for people in the last 6 months of life.2,3
Providing expert medical care, pain management, and emotional support, the goals for hospice care include promoting comfort and dignity, rather than prolonging life, and providing support for the patient’s family.3
Although more than 1.4 million individuals in the United States received hospice care in 2016, patients with cancer made up only 27% of this group. Patients spend just a median of 19 days in hospice care.4
Physicians will recommend hospice countless times while caring for patients with cancer. As much as patients are alarmed by this topic, we also dread these conversations. Although some of my patients receiving chemotherapy accept palliative care and have heard about hospice multiple times, it is still heartbreaking for both of us when I can no longer recommend therapeutic agents and instead recommend hospice care.
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