The Flinchum File
Thoughtful Economic Analysis and Existential Opinions

Hospice Misconceptions

10/15/2019

I served on the regional board for the National Association of Personal Financial Advisors (NAPFA) with Holly Donaldson and have great respect for her.  Below, I have copied her excellent latest article in LinkedIn on a very difficult subject.

The Hospice Decision: Sooner, or Later? 4 Misconceptions

Holly Donaldson, CFP®, CEPS

Holly Donaldson, CFP®, CEPS

Fee-only Financial Planner | Behavioral Economist See More
213 articles

“So she only has a week to live?” my friend assumed, when I told her an elderly friend had been placed under the care of hospice. “No,” I said, “What makes you think that?” “Well, I thought that was who they called when you only had a week or so to live.” “Not true,” I replied. Having served on the speaker’s bureau for my local hospice a long time ago, I had forgotten how many misconceptions there are about it.

Misconception #1: Hospice is for the very, very end of life.

The eligibility requirement is actually a prognosis of 6 months or less, assuming the patient’s terminal illness runs its normal course. (https://www.nhpco.org/wp-content/uploads/2019/07/2018_NHPCO_Facts_Figures.pdf )Some people live longer than 6 months, and therefore are cared for by hospice for even longer.

Misconception #2: Hospice isn’t a patient’s choice.

When my friend said “they” call hospice, she thought, as with other medical services, that the medical team would “know the right time” and do the calling. But studies show medical teams are more likely to try heroic measures for longer than necessary before having a hospice conversation. They aren’t to blame – they want the same thing the patient and their family want – for the patient to live longer. Yet, how to live the end of life is as much a patient decision as a physician one. It’s up to patients and their families to proactively ask about prognosis for quality of life, not just quantity, with and without hospice.

Misconception #3: The more money we spend at the end of life, the better it will go.

Actually, it’s the opposite. As reported by Forbes.com, “It seems that no matter how much money you use during that last year/month, if the person is sick enough, the effort makes things worse. A lot of the money being spent is not only not helping, it is making that patient endure more bad experiences on a daily basis. The patient’s quality of life is being sacrificed by increasing the cost of death.” Hospice’s primary goals are alleviation of suffering and promotion of informed patient and family choices. Neither of those cost as much as heroic treatments and surgeries.

Misconception #4: Accepting hospice care means giving up.

Anita Brikman, senior vice president of strategic communications for the National Hospice and Palliative Care Organization, says, “One of the most common misconceptions about hospice and advance care planning is that accepting one’s mortality means ‘giving up’ and that is not the case. Hope can be found throughout the experience of serious and terminal illness.”

If you have a friend, client, colleague, or family member struggling with an advanced terminal illness, get informed now, not later. Learn more about hospice care at www.nhpco.org, and/or start by reading Being Mortal, by Atul Gawande, M.D. Not only can hospice save money, more importantly, at one of life’s most difficult times, hospice can save everyone’s sanity.

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