“I shall always have the highest respect for human life and remember that it is wrong to terminate life in certain circumstances, permissible in some, and an act of supreme love in others.” The Oath of the Healer, Louis Weinstein

The oath is one of many variations on the Hippocratic Oath. The reality is different. Physicians are intensively trained to detect, treat, and cure acute injury and chronic disease. But, diseases that are treatable at younger ages, are only controllable at older ages, and ultimately the practical treatment options shrink to zero. However, the medical system is paid to detect, treat, and cure. It funds the entire sector.

An advanced directive and DNR orders are just one protective step at the very end of life. Caregiver, particularly those with Health Power of Attorney, must recognize when to move to Hospice. In cases of dementia, for example, the patient may not be able to ask. In other cases that don’t affect cognition they can. Either may need a caregiver who understands the differences between hospice and palliative care to actively advocate for it.

Hospice can start six months before, if your doctor certifies that you are terminally ill and expected to live less than 6 months. It is an expectation, not a limit. There is a process to extend it if you need to. Also, if want to stop at any time, you can also do that.

The hospice benefit lets you remain in the comfort of your home. It includes palliative care, and agencies use medication without worry of addiction, accommodate favorite foods or beverages, and relaxation with massage or music therapy. The objective is pain free comfort, not cure. If you need inpatient care, your hospice team arranges it.

Not surprisingly, hospice use grew from 22% of Medicare decedents in 2000 to 52% in 2019.