Badpuppy Gay Today

Monday, 16 March 1998

DYING: HOSPICE CARE OR ONE SPECIALIST AFTER ANOTHER?
Do We Need Only Cardiologists, Gastroenterologists, & Surgeons?
Findings Indicate Few Specialists Mention Hospice to the Terminally Ill


By Patricia Conklin

 

The plight of those who have been diagnosed as terminally ill is often made worse because they are sent by "professionals" from one specialist to another. Instead of spending their final days in relative comfort, their suffering eased by the best pain killers that medicine provides, dying people are often sent on a useless and expensive round of visits to specialists: oncologists, gastroenterologists, surgeons, and cardiologists.

Recent reports indicate that very few of these specialists recommend to their anxious patients the benefits of hospice. Instead, existing financial resources are spent on useless exams and a patient's remaining time goes into long waits in stuffy physicians' offices.

Hospice—an increasingly attractive alternative to such pseudo-medical chaos—is based on the premise that a dying person's last days should be spent catering to his or her comforts and spiritual needs. When a terminal diagnosis has been made, many have come to believe, exams by specialists can become overly burdensome rather than helpful.

To some, the peace that hospice can provide comes too late— merely as a last resort after discomfiting traipses through confusion, mechanical medical responses, and soaring medical bills. "Last minute hospice is not hospice," say hospice officials, "its only 'brink-of-death' care."

This state of affairs is often caused by a dying person's loved ones, those who refuse to accept a physician's terminal diagnosis. Relatives often insist that "no stone must be left unturned" long after it is clear that nothing can be done. Confusion and chaos, rather than peace of mind, is too often the result.

After the death of a relative or friend, the living sometimes openly admit to having caused their loved one more discomfort than was necessary because of such dogged insistence. Because few have had any extensive experience with what happens to a patient during endless rounds of visits to high-paid physicians, they remain unaware of how such doctors' visits can too often be little more than "turnstile" treatments.

A recent cartoon illustrates a patient's predicament, showing a receptionist addressing a skeleton in the waiting room: "The doctor will see you now."

Hospice care in the United States is currently used by less than 20% of those who are dying. Specialists coveting the financial rewards they reap from the dying have been known to vigorously oppose hospice options. When a patient says, "Doctor, I want to go to hospice," the specialist too often responds, "No, no, you aren't that sick yet."

Hospice—comfort zones where people go to die-- got its start in England. In the United States, hospice care is more typically rendered at a patient's home. Nurses and social workers keep a daily watch on a dying patient, providing pain-killers and sound advice to distraught loved ones.

Dr. Nicholas Christakis, an "end-of-life" specialist from the University of Chicago, says that studies show an "incredibly high" sense of gratification among survivors after a patient uses hospice services. Dying patients too, he says, are more likely—under hospice care—to die in a way that best fits their preferences: in bed, at home, and as free from pain as can be made medically possible.

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