Hospice: What Country Will Provide the Best Services For Your Loved One?
THOUGHT OF THE DAY. A few years ago I was the keynote speaker at Calgary Hospice and also conducted a workshop where I presented a unique model for seamlessly integrating hospice into culture.
I looked at data from various countries and found although much was available, some were difficult to compare while others were dated. But two statistics were enlightening: the population percentage who die in hospice (stand alone facility or in-home service) and the average length of stay.
Country% Dying in Hospice Average stay
United States 44% 26 days
Canada 16-30% 13.5 days
U.K. 30% 12-14 days
Australia 20% 12.6 days
Money and Nonsense
Much of the discussion today about hospice involves funding and self-serving political comments about death panels. While funding is important, a more significant concern should be why the percentage of people referred to hospice is low and why the stay is short.
There is speculation that physicians are reluctant to refer patients to hospice because of personal issues about death. Families fear that discussing hospice with a dying loved one will cause them to lose hope.
Everyone Needs to Step Up
Our fear of death in the United States is mirrored around the world, even in countries where culturally you expect a greater acceptance of it. When lecturing in Taiwan, a Daoist/Buddhist country, I found the reluctance to accept the terminal condition of a loved to be no less than in the States.
What’s most unfortunate about these statistics is various studies show dying in hospice produces less anxiety for patients and families. People also lived longer under hospice care than in acute facilities.
The takeaway for 2015. Yes, funding is critical for the delivery of quality hospice services, but it’s time to push for more open discussions of end of life issues, if for no other reason than to provide compassionate care for our loved ones.
I’m reminded of the great baseball movie, A Field of Dreams, where a voice in the sky says to an Iowa corn farmer, “If you build it, they will come.” I think the same will be true if honest end-of-life discussions become a central focus in countries wanting to enhance hospice care. If you want funds to ease death, talk about the need for it, and compassionate people will respond.
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