"In my end is my beginning"

                            -Mary Queen of Scots

COMMON HOSPICE MYTHS VS FACTS…

There are many serious misconceptions about hospice services.
For instance:

MYTH:
Only the elderly can be admitted to hospice care.
FACT:
ANYONE who has been diagnosed with a life-limiting illness can be admitted. In 2002 High Peaks Hospice had 4 patients under the age of 18 and most recently a newborn.

MYTH:
Once you are admitted to hospice you can no longer see your own physician.
FACT:
Your own personal physician is a part of the “hospice team” and is as involved with your care as you wish.

MYTH:
Hospice should be contacted when death is imminent.
FACT:
Hospice services are most beneficial to patient and families when a patient is referred as soon after terminal diagnosis as possible.

MYTH:
Once you are admitted you have to stay in hospice care and cannot leave.
FACT:
An individual can opt to be discharged from hospice care at any time. For example -if a new an innovative treatment for his or her particular illness is discovered a patient may leave hospice care to pursue this treatment. Or maybe a family decides to move or feels that hospice care is not for them – they may choose to be discharged from hospice care.

MYTH:
Hospice doesn’t offer any treatment.
FACT:
One of the primary goals of hospice care is to bring dignity to the dying. Therefore hospice nurses are specially trained in pain management medications and techniques.

MYTH:
Patients and families must put up with constant intrusion of hospice staff into their home.
FACT:
The hospice team works with the patient and their caregivers to provide services that they wish and at times convenient to them.

MYTH:
Hospice services are only provided in a hospice residence.
FACT:
Hospice services are provided in any setting the patient wishes that is willing to work with hospice – most often in the home.

MYTH:
Hospice only works with cancer patients.
FACT:
Hospice care is offered to anyone with a life limiting illness.
 
HOSPICE PAIN MYTHS*…
 
MYTH #1:
Morphine is offered to patients when death is imminent.
FACT:
It is the degree of pain that dictates which medicine is used – not the stage of a terminal illness.  We start with the mildest medication and if it works, stop there. If not, we move on, to narcotics when it is appropriate. Some people never need narcotics and others will require it for quite a while. You can live for a long time on narcotics.

MYTH #2:
People who take narcotics will become addicted.
FACT:
Drug addicts are driven by their need for narcotics. Hospice patients usually do not have drug seeking behavior. When their pain is in good control, they don’t desire more narcotics. Sometimes dosage can even be decreased. If a patient takes narcotics for a while, their body does become used to it and it should not be suddenly stopped because side effects could occur. However, hospice patients on narcotics are not considered to be addicts.

MYTH #3:
People on narcotics are too sleepy to function.
FACT:
When patients start to take drugs like narcotics, they often feel drowsy for a few days. But their bodies usually quickly build up a resistance to the sedating effects. Most patients whose pain is well controlled on narcotics are not bothered by unusual sleepiness. Some people, however, notice a difference in their alertness and might choose somewhat less than perfect pain control as a trade off.

MYTH #4:
People on narcotics die sooner because their breathing is weakened.
FACT:
Fortunately, patients quickly adjust to any effect that narcotics may have on their breathing. We prescribe a small initial dose, gradually increasing it if needed. So rarely do breathing problems occur, they are usually not even listed as side effects. In fact narcotics is a drug of choice for breathing distress in people with end-stage heart or lung disease: it makes their breathing more comfortable.

MYTH #5:
Prior strange feelings after narcotics were allergic reactions.
FACT:
Of course you can be allergic to narcotics just like any other medicine. But feeling strange is usually not a sign of narcotics allergy. Some people may have unpleasant mental sensations when they start to take narcotics but that is not an allergy, and it might never recur. There are other opioids available for those people who are truly allergic to narcotics.

MYTH #6:
Morphine must be given by injection.
FACT:
Hospice has been a leader in demonstrating the effectiveness of narcotics and other opioids taken orally.  Even people who required injections of narcotics in the hospital (the most common way of giving narcotics there) will probably be able to be well controlled on oral narcotics at home. There are also long-acting preparations of narcotics which can be given every 12 hours, or skin patches which can be applied every 72 hours, to simplify the routine of pain control.

MYTH #7:
People should not take Morphine before their pain is severe, lest it loses its effect.
FACT:
There is no upper dose limit to the use of narcotics or other opioids. If pain increases we can increase the dose; this is true of very few other medications. Using it when it is needed early in the course of a terminal illness does not mean that it won’t continue to work later in the disease.