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Geriatrician
Hospice care is a type of palliative care for people with terminal diseases, focusing on relieving suffering rather than improving chances of survival. Hospice is a treatment choice for people who have less than six months to live, wherein they choose to receive pain medications and nursing support at home rather than traditional treatments and surgeries focused on curing the disease. The goal of hospice is to focus on well-being in the moment. Ironically, Gawande illustrates that hospice not only lessens suffering, but also it can actually help people live longer than those who choose traditional treatments.
Hospice Quotes in Being Mortal
The Being Mortal quotes below are all either spoken by Hospice or refer to Hospice. For each quote, you can also see the other terms and themes related to it (each theme is indicated by its own dot and icon, like this one:
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Chapter 6
Quotes
The difference between standard medical care and hospice is not the difference between treating and doing nothing, she explained. The difference was in the priorities. In ordinary medicine, the goal is to extend life. We’ll sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, chaplains, and social workers to help people with a fatal illness have the fullest possible lives right now—much as nursing home reformers deploy staff to help people with severe disabilities. In terminal illness that means focusing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as feasible, or getting out with family once in a while—not on whether Cox’s life would be longer or shorter. Nonetheless, when she was transferred to hospice care, her doctors thought that she wouldn’t live much longer than a few weeks. With the supportive hospice therapy she received, she had already lived for a year.
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The result: those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice far earlier, experienced less suffering at the end of their lives—and they lived 25 percent longer. In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.
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Chapter 7
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We witnessed for ourselves the consequences of living for the best possible day today instead of sacrificing time now for time later. He’d become all but wheelchair bound. But his slide into complete quadriplegia halted. He became more able to manage short distances with a walker. His control of his hands and his arm strength improved. He had less trouble calling people on the phone and using his laptop. The greater predictability of his day let him have more visitors over. Soon he even began hosting parties at our house again. He found that in the narrow space of possibility that his awful tumor had left for him there was still room to live.
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Chapter 8
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When our time is limited and we are uncertain about how best to serve our priorities, we are forced to deal with the fact that both the experiencing self and the remembering self matter. We do not want to endure long pain and short pleasure. Yet certain pleasures can make enduring suffering worthwhile. The peaks are important, and so is the ending.
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Get the entire Being Mortal LitChart as a printable PDF.
Hospice Term Timeline in Being Mortal
The timeline below shows where the term Hospice appears in Being Mortal. The colored dots and icons indicate which themes are associated with that appearance.
Chapter 6
One morning, Gawande goes on patient rounds with Sarah Creed, who works with the hospice service. Hospice care is given to patients who have a life expectancy of less than...
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...why Creed is still trying to extend Cox’s life. Creed says that the goal of hospice is for people with a fatal illness to have the fullest lives possible in that...
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...his fight with pancreatic cancer. The whole lower half of his body swells with fluid. Hospice workers set up a pain pump, knowing he only has a few days to live....
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...after a few days, they even go out to a restaurant (though Dave doesn’t eat). Hospice staff explain that Sharon shouldn’t give him intravenous feedings because of the swelling. As a...
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...and surrounded by family. A week after that, Lee Cox dies, too, of cardiac arrest. Hospice is a new kind of guide to the art of dying, but it is a...
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...another round of chemo, she wakes up and has extreme trouble breathing. Rich has no hospice number to call, so he dials 911. At the hospital, Sara is diagnosed with pneumonia....
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...the jury verdict shook the insurance industry. In 2004, Aetna tried a different approach, increasing hospice options. The company allowed patients like Sara to continue medical treatment as well as having...
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Aetna ultimately finds that hospice’s benefit lies in patients’ ability to talk to someone knowledgeable about their daily concerns, and...
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...preventing and relieving suffering. Those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice earlier, experienced less suffering, and lived 25 percent longer. “If end-of-life discussions were a drug,...
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...too much difficulty swallowing. He cycled through hospitals and rehabs until he decided to start hospice care. He died five days later.
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...chemotherapy. They had hours-long conversations about how treatments likely wouldn’t work. The patient opted for hospice and spent a month with his family before his death. Later, his parents thanked the...
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Chapter 7
...only 17 percent did in the 1980s. In 2010, 45 percent of Americans died in hospice care—either at home or at a hospice facility or nursing home.
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The Gawandes talk about joining Athens Village; the only other option is home hospice care. They meet with a hospice nurse, who impresses Gawande. She makes clear that she...
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Chapter 8
...could suggest a whole new range of treatments and surgeries, or he could talk about hospice.
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...for relieving her nausea and pain. Three days later, she leaves to go home with hospice to look after her. A few days later, Gawande visits her after work. She feels...
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...have taken it as the only chance for control. But Gawande convinces her to try hospice, which would at least get her home and might help her more than she thinks.
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A few days later, Peg calls and wants to resume teaching Gawande’s daughter. Hospice allowed her to manage her daily difficulties and regain the things she loves, which in...
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Eventually, Gawande’s father’s story ends as well. After he starts hospice in the early spring, he has difficulty regaining a sense of normalcy as his body...
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...up after taking a strong dose of pain medications. She calls the hospital, not the hospice agency, and they bring him to the emergency room. He has pneumonia and is at...
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