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Tue., July 20, 2010

Editorial: Hospice care fills void left at limits of medicine

As many as 80 percent of Americans say they want to die at home, and yet many of them spend their final days in medical settings. Examining the reasons reveals some uncomfortable truths.

Our system of medicine reinforces a never-say-die attitude. As long as there is the slightest chance to extend a life, the default position is to go to the extreme with testing and treatments.

We’re generally not comfortable talking about death, even though all of us die. Rather than face up, we cling to hope and the possibility of miracle breakthroughs. Plus, all of those tests and procedures give us something to talk about in the final days. Giving in to death is deemed defeatist. To some doctors, it is an affront to their abilities to concede that nothing more can be done. They feel they must “win.”

Working against the grain, many medical professionals have become advocates for advanced-care directives, palliative care and hospices. Though many people do not want to be hooked up to medical equipment or drugged into oblivion to gain a few extra days or weeks, these wishes aren’t often communicated to hospitals. A recent study financed by the Robert Wood Foundation found that most seriously ill people want to die in their homes, but that the common practice of most hospitals is to switch into rescue mode before any serious discussion between patient and provider occurs.

Some patients simply want ways to control the pain and discomfort as they live out their final days. They need compassion, and so do their families. This is why hospice care is so valuable. It provides a setting so that patients get the peace and comfort they need.

Hospice House, a 12-bed facility in Spokane, opened in 2007. Hospice of North Idaho, which also has a dozen beds, will open soon. Construction on the Prairie Avenue facility began Monday.

These facilities provide a homelike atmosphere that is far removed from intensive care units. Some patients die at hospice. Some use it to transition from medical settings to their homes. Family and friends are accommodated so they can celebrate or say goodbye at their own pace. When death does occur, counseling is provided for those who want help accepting it and moving on.

Hospice care is an honest acknowledgment that medical science has its limits and that a fatal illness affects more than the patient. A community like ours is fortunate to have facilities that meet such common wishes.

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