Looking Ahead: Making the End-of-Life Care Decision

End-of-life issues are difficult to face. But the stress of coping with a terminal illness can be lessened by talking with your doctor and family members about options as the disease or condition progresses.

Pennsylvania Medical Society member physician Deborah Way, MD, medical director of the Hospice of Philadelphia, encourages terminally ill patients, their families, and their doctors to have that difficult discussion.

“Do you want to prolong life as long as possible? Or does quality of life matter more? The answer is different for everyone,” she says.

Hospice care focuses on quality rather than length of life. The goal is to enable patients to continue an alert, pain-free life and to manage symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones.

“Once a decision is made, if hospice care is chosen, then medical treatment shifts from curative to palliative, with comfort being first and foremost,” adds Dr. Way.

A hospice team—doctors, nurses, social workers, counselors, home health aides, clergy, therapists, and trained volunteers—work together to treat the physical, emotional, and spiritual needs of the patient. Care most often takes place at home but is also provided in freestanding hospice centers, hospitals, nursing homes, and other long-term care facilities.

“I wish more families would consider hospice sooner than later,” notes Dr. Way. “Frequently, we treat patients in their last two weeks of life. But we could do so much more to improve their quality of life if contacted earlier on.”