Whether you’re faced with a serious illness or have a loved one who is, the word “hospice” can evoke a mix of emotions. For some, it represents compassionate care and support at the end of one’s life. For others, it can be clouded by misconceptions and fears, which, sadly, prevent some from seeking hospice care until the very last stages of life.
For this month’s blog, we sat down with Registered Nurse and Patient Care Manager Kelly to address some common myths surrounding hospice care.
Myth 1: Hospice and the use of morphine hastens death.
This is perhaps one of the most pervasive and concerning myths. Kelly explained, “We often hear concerns about opioids like morphine and the fear that they will speed up the dying process. However, the reality is quite different.”
Morphine is a medication frequently used in hospice care that is primarily prescribed for pain management and shortness of breath. For pain, morphine works on nerve receptors, providing rapid relief. For shortness of breath, it helps open blood vessels, improving circulation in the respiratory system and allowing patients to take deeper, slower breaths instead of shallow, rapid ones.
“It’s important to understand that morphine goes through the system quickly and is very closely monitored by our care team,” said Kelly. “For those who need morphine, addiction is not a concern in the hospice setting, as the hospice team’s focus is on providing comfort.”
The idea that hospice hastens death often stems from the fact that people tend to consider hospice care when their illness has already progressed significantly.
“Studies have shown that starting hospice care sooner can allow patients to live longer,” Kelly stated. “The body is naturally shutting down due to the underlying disease, and hospice focuses on managing symptoms and enhancing quality of life, not accelerating the end.”
Kelly encourages families to be proactive: “Attend doctor’s appointments with your loved ones and ask questions. Once treatment options are exhausted, it’s time to have those difficult conversations about what comes next. Often, patients suffer unnecessarily for too long.”
Myth 2: Morphine will make my loved one constantly sleepy and unresponsive.
The purpose of going on hospice is to ensure the patient’s comfort and allow them to live their remaining time with dignity and as fully as possible. Kelly clarified, “While we want our patients to be comfortable, the image of someone constantly sleeping until the end is not the typical hospice experience.”
She shared, “We have many patients on our services who we talk to every day and who are living their lives to the best of their ability. Some even go on vacations. Morphine is typically introduced at the end of one’s life when the body is beginning to shut down, and our aim is simply to alleviate discomfort.”
Myth 3: Hospice is the same as euthanasia or physician-assisted death.
A common misconception is that hospice is the same thing as physician-assisted death. In Oregon, the Death with Dignity Act allows eligible people to request and receive medication to end their lives.
“Hospice of Redmond supports the patient’s choice to pursue this option or not,” said Kelly. “While we can provide information about the Death with Dignity Act and help patients contact the relevant organization, our role is to provide comfort care, and support throughout the natural progression of their illness.”
There are eligibility criteria for people interested in Death with Dignity (six months or less to live, the same as hospice), and the process differs from hospice care. The patient must make the request, undergo mental health evaluations, and be capable of self-administering the medication. Hospice staff is not present when the medication is taken.
Myth 4: Palliative Sedation is simply making the patient unconscious until they die.
Palliative sedation is another area where misconceptions can arise as some people confuse going on hospice with meaning the patient will be sedated to the point of unconsciousness. Palliative sedation is considered a last resort and is used only when symptoms are not relieved with other options. Palliative sedation is rarely used as most hospice patients find acceptable relief without having to be sedated.
Kelly explained, “Lorazepam and Haldol are medications we might use, in addition to pain medications, to manage distressing symptoms like terminal agitation and anxiety in the final stages of life. The goal is to alleviate suffering, not to simply sedate the patient.”
The gradual shutting down of the body is because the underlying disease is progressing, not the palliative sedation itself. In fact, Kelly pointed out, “Patients with poorly controlled pain, shortness of breath, and agitation tend to die sooner due to the immense stress their suffering causes.”
Research has shown that palliative sedation does not hasten death. In fact, numerous studies published in leading medical journals support this conclusion.
Myth 5: Hospice is a place.
Patients who receive hospice care sooner often experience positive outcomes. “Many families express gratitude because their loved one is no longer suffering,” she said.
It’s also important to remember that hospice is a service one receives, not just a place. While there is one hospice house in Central Oregon (with specific admission criteria like uncontrolled pain), hospice services can be provided wherever a patient calls home.
While hospice doesn’t offer caregiving, the service ensures the patient is well-cared for.
“Hospice provides a team that works together to ensure the patient is well cared for,” said Kelly. “This team includes nurses, doctors, social workers, chaplains, and volunteers available to address the patient’s and family’s needs.”
Finally, Kelly highlighted that hospice allows for the natural progression of disease while ensuring comfort and dignity for the patient and support for their loved ones.
Hospice of Redmond is dedicated to providing compassionate and informed care to Central Oregonians in need. They hope to empower individuals and families to make informed decisions about end-of-life services that bring comfort and peace during challenging times.
If you have questions about hospice or any of their other services, please don’t hesitate to contact them.