This can be a sensitive topic for many; please be prepared before reading this if you are one of them.
HOSPICE
Let me get out in front of this by saying that I have no “must believe” POV on this. My mom died in hospice. She chose to go that way. Others I know have decided to die at home with family without the assistance of hospice. 100 years ago dying at home was preferable to dying anywhere else.
Yet, you and your loved ones SHOULD have a talk about this issue. Why?
[Before we talk about THAT maybe you should take an hour and a half to find and re-read your estate plan documents. Do you still want to give $50,000 to the Findlemann Bird Sanctuary where Mr Findlemann’s secretary was caught dipping into funds for her own lavish lifestyle?]
1. Your medical insurance company definitely prefers hospice. They save a bundle of money on this vs hospitalization to save your life. The point of hospice is to assist you in dying, not to assist you in living. They aren’t going to use respirators, blood transfusions, or feeding tubes. They may use drugs that lower your heart rate (at the same time that they relieve anxiety and/or pain). In other words, you may die sooner than if you were hospitalized…perhaps hours or maybe weeks sooner. Is that OK with you?
2. Your doctor may prefer it. They are busy with ordinary sick people who will probably recover. Some may consider it difficult to spend effort on a lost cause. That is hard on their peace of mind. They would rather help people live and recover. The doctor who spoke to the family following my mother’s major stroke suggested we do not try to help her to recover. He thought her a “lost cause,” but she lived another 4 months before going to hospice. She talked with her family, hugged and kissed her husband, and had a birthday party in her hospital room. Was that a benefit? Yes. The family had a clear conscience that they had done all they could to give her a chance at full recovery. If we had not fought for her, who would have? (No one!) Personally, I don’t regret the efforts. I spent many days and nights in her room, reading to her and talking about ordinary things. I know she appreciated the time with her family. The family needs to have a healthy feeling that they have done what they could (not heroic efforts, but sufficient efforts).
3. Who is making the decision? This is crucial. I recommend a “living will.” That is a legal document that is written and signed by a person long before he or she reaches the critical point. If you don’t have one, you have to rely on WHOM? Your heirs? Your loving spouse? Your greedy spouse? The doctor? The insurance company? Somebody is going to make that decision. It should be you.
4. Once hospice care begins you won’t likely recover. A few do (one study showed that about 13% survived longer than 6 months), but that does not mean the terminal illness had been cured. There are reasons so many in hospice die. Well, one obvious reason is the person has a terminal illness. However, another less obvious reason is the palliative drugs given. Speaking of those drugs, many are products that would not necessarily be prescribed for the length of time if the person was going to recover. Some stop the intestines from functioning properly. Some slow the heart rate or lung function. Many cause unclear thinking. Once on these drugs you are not likely to recover even if the cancer miraculously disappeared (it won’t). A third reason is that, unless you direct otherwise, some hospice centers stop feeding and hydrating the patient. Some die of dehydration before they die of the cancer. Oh, I think you should study this issue carefully, discuss it, and have a living will. This is not a “one size fits all” issue. My personal living will directs that I shall be given food and hydration if possible.
5. There are other key factors. For example, how it affects your family. Few families can handle a loved one dying naturally at home. It is hard. There’s much to do, washing your loved one’s body every day. Cleaning up messes. Providing essential health care, like checking for bedsores and changing sheets. Cooking special diets. Dealing with a person in pain who may be crying or moaning. Round the clock care. The big deal is that HERE is where it “takes a village.” The African proverb is backward. Raising a child is simple compared to caring for the dying. You need at least 2 good helpers and someone to give you at least one day off every week. It is expensive (insurance doesn’t like to pay for this even though they easily volunteer for hospice). The caregivers have little rest until the end; then there’s suddenly too little to do. The benefit of this choice is the knowledge that your family did what they could to make your final days better. That could be a gift to them.
So, this is clearly something you should want to research, talk about, and make clear decisions about when you are of sound mind and body.
I hope I never need palliative care. I also hope I never need a week of intensive care. I’d rather just go quickly in my sleep (“not like the other people in the car I’m driving”). I’ve seen the hard, lingering deaths. I don’t begrudge those individuals for a moment of their hard-fought attempts at survival. We have the technology and we should be willing to use it or do away with it. If it is OK to use a technology to help a 12 year old, then its OK to help a 92 year old with it. Who are we to draw a line in the sand?
An 85 year old should have hip replacement if she falls and breaks a hip joint. She’s earned the privilege just by surviving to 85. Its either that or we make “administrative” decisions (instead of “medical” decisions). I’m against “administrative” decision making.
So, the decision is YOURS. Society shouldn’t make your decision. If you want to do everything possible to survive…fine. If you merely want to experience no pain…fine. If you are tired of living, then you should be allowed to slip away naturally. Here is where “Its my body” actually matters because it is your body ONLY, not another’s, we are talking about.
Copyright 2025 Donald Whelpley
[PLEASE NOTE that Don is always open to discussing the thoughts and opinions he shares here and welcomes comments as shared in the comment section. He doesn’t use other social media platforms and won’t see whatever you’d like to share with him if you post it elsewhere.
ALSO, Don is always open to offer his thoughts on various topics. If you have a specific request, you can let him know in a comment; he reads – and replies to – them all. ~ Sherry]
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