As a follow up to yesterday's discussion about the last 6 months of life in those with heart failure, the Archives of Internal Medicine also published a study looking at the use of hospice in men dying of prostate cancer between 1992 and 2005.
The good news is that just over half (54%) were enrolled in hospice. The bad news, the average length of stay prior to death was just 24 days while one in four enrolled within seven days of passing. So yes, the message is getting out to offer palliative care but it's not getting through early enough.
Despite what you may read or hear about immortality moving within our grasp, that is not the case. So to encourage thinking otherwise is disingenuous for everyone involved. Instead, even as we first attempt a cure, we should also be just as focused on offering palliative care to counter all the symptoms and side effects of said therapy.
And we should initiate a discussion as to when to focus less on cure and more on caring, with the possibility of transitioning to a hospice facility when the staff there can do the most good in preparing the patient and family for one of life's certainty. As noted two weeks ago, there are studies that demonstrate higher quality of life and prolonged survival in those patients who elect hospice care over narrowed focused continued attempts at cure.
As individuals with advanced cancer transition from curative to palliative care, the focus shifts from treating the disease to treating the person as a whole. Since, in hospice, we focus on the physical, emotional, spiritual, social, and economical issues related to the disease, palliative care represents a ‘paradigm shift’ in caring for individuals faced with a serious illness. It is for this ‘holistic care’ that time and time again we hear patients and families say “we wish we would have know about hospice sooner”.
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