Hospices Lend Care, Comfort to Dying Patients

Hospitals can be horrible places to die. They are designed for the living, and too often, dying patients are kept alive unwillingly or abandoned as a lost cause.

“That may be a very sad fact, but it is a fact,” Jay Mahoney said. “Doctors have only so much of themselves that they can give. A patient who is going to be cured needs their skills more than someone who is going to die.”

Mahoney is president of the National Hospice Organization in Washington, a 10-year-old nonprofit group devoted the care and comfort of the dying.

“We are trying to treat the dying patient the way they would like to be treated--as a person,” Mahoney said. “We try to alleviate their pain, but also to pay attention to their needs for emotional comfort and the need to keep living as full a life as possible.”

The hospice movement in the United States is relatively young, growing out of a program that began in England and quickly spread throughout Europe.

“A hospice in England is a place, as a rule,” Mahoney said. “A hospice program here can be a place, but it can also be people who come to a dying person’s home or visit a hospital.”

1,700 Groups Nationwide

At present, the NHO boasts a network of 1,700 groups nationwide that provide care and or lodging to the terminally ill. The AIDS epidemic has caused significant growth of hospices in places like San Francisco and the Northeast, but the South is still severely lacking in facilities, Mahoney says.

The ultimate goal of hospices is to ease a person into death, with as little pain as possible, Mahoney said. This means not being stingy with pain relievers, which are often given continuously so the patient need not even fear the pain will return, but also trying to keep the patient alive in the spiritual sense.

For some patients, pain relief means daily “Brompton’s cocktails,” a liquid mixture usually containing morphine, a stimulant to combat drowsiness, and anti-nausea drug and flavoring. The brew was developed in England, where it often contains heroin, which some experts claim is a superior pain reliever but which is illegal in the United States.

However, Mahoney said he does not believe it is necessary to legalize heroin.

“For the vast majority of patients, we have the tools to control their pain,” he said.

Besides being more humane, hospices are generally less expensive places to die than hospitals. Recognizing this, the federal government made hospice a permanent benefit under Medicare.