SAN FRANCISCO (KCBS RADIO) – Since President Jimmy Carter announced early last year that he was entering hospice, this type of end-of-life care has been on more Americans’ minds.
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Dr. Kai Romero, chief medical officer of UCSF affiliate By the Bay Health, joined KCBS Radio’s “As Prescribed” with Alice Wertz to clear up some misconceptions about hospice, and to explain how patients can take an active role in their care.
“I'll start by saying one of the common misperceptions about hospice is that hospice is a location,” she said. “And so often we’ll hear people say, you know: ‘I don’t want to leave my home. I don’t want to go to hospice.’ In fact, hospice is a benefit. It’s afforded to you by your… insurance or Medicare.”
For example, when Carter announced he would be entering hospice care, some were surprised that he also planned to stay at home.
“All of us will die. And I think sometimes the easiest way into the conversation is not by necessarily bringing up death’s dying end of life, but starting by talking about the meaning and purpose and things that bring someone joy in their life and trying to get a sense of their values in that way,” Romero said. “That can go a really long way to dictating how people are imagining the end of their lives. In general, people don’t completely change as they’re dying. The person that they were before they began dying is the person that they continue to be in their dying process.”
She explained that hospice patients can spend their time gardening if that what makes them feel happy, or spend time around their loved ones. Others prefer to be in a hospital setting around clinicians.
According to National Hospice and Palliative Care Organization, 1.72 million eligible Medicare beneficiaries chose hospice care in 2020 representing a 6.8% increase from 2019. That was the largest recent year-over-year increase in the number of Americans choosing hospice care, both in absolute numbers and as a percentage, the organization said.
Romero said that patients sometimes don’t understand the options they have on the path to hospice.
“Oftentimes what’ll happen is that people will enter into medical care without an awareness that medical care is not reproducible outside of the hospital setting,” she said. “And so, they kind of begin on this kind of railroad.”
With the UCSF network, Romero works to educate patients on their options and make sure they direct how things go. She likened the process to creating a birth plan.
“You don’t have just anybody in the room when you’re giving birth… you have the people that are the most essential for you to get through this physically difficult period as best you possibly can,” she said.
Listen to this week’s “As Prescribed” to learn more. You can also learn how UCSF is improving child health with nature here.
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