Let’s Talk About What Matters: Don’t Delay Hospice — It May Not Be What You Think
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BY KATIE BROWNSTEIN | Director of Advanced Illness Management, Samaritan
A single interaction with another person can change a mind, a mood, or even a day. But one interaction changed my entire career. Fifteen years ago, when I was just starting my career as a new nurse, one patient shaped my entire outlook on how to provide care.
This patient lived with a breast cancer diagnosis for years, but she had always chosen quality of life over aggressive treatment. But as her disease progressed, she endured ever-increasing pain, anxiety and isolation, and ended up living out the rest of her life in the hospital. We talked one night, and she shared that this wasn’t where she wanted to be, but didn’t know what else to do. In that conversation, I realized something: this patient who valued quality of life first and foremost shouldn’t have to give up the things that mattered most in her last days. She didn’t choose to live her life in a hospital, so why must she die there?
That was when I decided I wanted to provide care that focused on the human side of serious illness. I went back to school for advanced training to become a palliative care nurse practitioner. And after a decade of practice and honing my skills, I eventually came to provide care to patients across South Jersey with Samaritan.
That patient I served as a young nurse was not an isolated incident. Many families have told me throughout my career, and still tell my colleagues at Samaritan, that they wished they had called for hospice or palliative medicine sooner for their loved one. They valued the time where the focus of medical care had shifted to include the comfort, support, and peace that these forms of practice can bring.
Too often, patients decline the offer for palliative medicine out of fear that it may signal a change in priorities. In reality, palliative providers are specialists who work in tandem with the rest of the medical team to focus on relieving the symptoms, pain, and stress that go along with a serious illness. This is a team-based approach that works to improve quality of life while a patient receives curative treatment, which is aimed at curing a disease or illness.
Similarly, many people delay hospice because they fear that hospice means giving up hope. Instead, hospice is not about giving up, but is about pursuing the highest levels of medical care to focus on comfort, dignity, and spending time with loved ones.
Hospice is designed to enhance quality of life for those facing serious, life-limiting illness as they approach the last several months of life. It focuses on managing pain and symptoms, honoring personal wishes, and creating opportunities for comfort and connection. Hospice helps patients live each day with dignity and as much comfort as possible.
I have seen firsthand how hospice and palliative medicine support more than physical needs. Both disciplines center the whole person, recognizing that emotional and spiritual needs are just as important as medical ones. They both also embrace the family, providing guidance and compassionate support as loved ones navigate difficult decisions and complex emotions.
Some of the most meaningful moments I have witnessed happen when hospice allows people to be truly present: A son sharing stories with his father at the bedside. A spouse finding the words that had gone unspoken for years. Grandchildren gathering to laugh and reminisce. These quiet moments are deeply important. Hospice creates the time and space for them to happen.
Hospice and palliative medicine also help share the work placed on family caregivers. Nurses, social workers, chaplains, aides, and volunteers work together to provide reassurance, education, respite, and support. The goal is to help caregivers feel confident and cared for throughout the journey.
The truth is that hospice is not about the last days of life. When introduced earlier, hospice can provide months of meaningful support that allow patients and families to focus less on crisis and more on being together.
That’s why I encourage everyone: Don’t wait until there is an emergency to start the conversation. Don’t wait until your loved one’s last days to ask about hospice. Talk to your doctor about whether palliative medicine or hospice may support your goals. Even if you are not ready to make a decision, asking questions can arm you with facts and a prognosis, and provide clarity and peace of mind.
Kaytie Brownstein, MSN, is a Board-Certified Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC) and Advanced Certified Hospice and Palliative Nurse (ACHPN).
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