Mark Harvey: You may qualify for hospice — and you’re not required to die

Hospice is one of the unintentionally best-kept secrets in this business.

By Mark Harvey

I know what hospice is: It’s one of the unintentionally best-kept secrets in this business. But we’ll get to that.

And because I’ve been ricocheting off hospice for so long, I wasn’t at all sure that I could succinctly define it for you; thus, uncharacteristically, I actually looked it up! Here’s the definition I like the best:

“Hospice offers medical care toward a different goal: maintaining or improving quality of life for someone whose illness, disease or condition is unlikely to be cured. Each patient’s individualized care plan is updated as needed to address the physical, emotional and spiritual pain that accompanies terminal illness. Hospice care also offers practical support for the caregiver(s) during the illness and grief support after the death. Hospice is something more that is available to the patient and the entire family when curative measures have been exhausted and life prognosis is six months or less.”

It goes on. I won’t.

So, basically, hospice care is not about trying to cure a terminal illness; it’s about improving the quality of the life that the patient has left. And it does a remarkable job of doing that.

Obviously, there’s a huge emphasis on pain and symptom control, but hospice also helps with therapies, medical equipment, dietary counseling, etc., along with a lot of help for the resident caregiver(s)/family — even spiritual support.

Hospice is covered by Medicare, Medicaid, VA and pretty much all “private” insurances. Does that impress you? It should, because it implies that hospice actually works.

And, being who I am, I’d immediately want to know: What does it take to qualify for hospice?

Well, a hospice physician and another doc (often, your own) must certify that the patient’s life expectancy is likely to be six months or less. Also, the patient isn’t pursuing a cure, because hospice isn’t about a cure, remember? It’s about the quality of the life that’s left.

I know what you’re thinking, so let me say what I always say at this juncture: You will not be required to die.

In fact, it isn’t uncommon for hospice patients to “rally” — to actually get better for a while — because hospice helps that much! So, those six-month certifications can be extended (indefinitely) and/or a person could go off hospice care, then return later. Thus, no one is required to die.

The biggest mistake that terminally ill patients (and their caregivers) make is waiting too long to get on hospice. Seriously! Folks tend to wait until too close to the end, when they could have been getting incredible help and support from hospice all along. Life could have been better. Easier. Less stressful. Less painful.

Is that understandable? Well, sure: Many folks don’t want to have to face the fact that the inevitable end is within sight. “If we don’t acknowledge or admit this, Death won’t notice us and move on to the next poor slob.” Unfortunately, it just doesn’t work that way, so a lot of help and comfort is sacrificed on the altar of denial.

Is that smart? No, but it’s understandable. And it takes courage to decide that we’re more interested in the quality of the life left than we are in the quantity.

Which is also why hospice is one of the unintentionally best-kept secrets in this business: We don’t like to talk about death. We don’t like to acknowledge it, admit to it or concede to it. We want to carry on in our bubble of immortality. I completely understand — and I completely disagree, because I’ve seen what hospice does, over and over and over.

You can call any of the numbers at the end of this column to get more info on hospice, as well as local hospice providers. And if you or someone you love is almost certainly in the home stretch, please don’t wait.

If you’ve already established your immortality, I suppose you don’t need to waste your time; for the rest of us, this is a very important subject.

Remember, no one will be required to die.

Mark Harvey is the director of information and assistance for the Olympic Area Agency on Aging. He can be reached by email at; by phone at 360-532-0520 in Aberdeen, 360-942-2177 in Raymond, or 360-642-3634; or through Facebook at Olympic Area Agency on Aging-Information & Assistance.