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Hospice care does not hasten death, study shows

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http://www.sciam.com/article.cfm?alias= ... rc=reuters

By Megan Rauscher

NEW YORK (Reuters Health) - Researchers hope a new study will help dispel the myth that medications used in a hospice to relieve pain and other symptoms hasten death. On the contrary, hospice care may actually prolong life, they've found.

"This should be reassuring to those faced with life-threatening illness and their families who are considering hospice care," Dr. Stephen R. Connor of the National Hospice and Palliative Care Organization based in Alexandria, Virginia, told Reuters Health.

Hospice care is not "giving up." It is choosing to live life fully to the end, he said.

Connor and colleagues analyzed the survival of 4,493 terminally ill patients who died within a 3-year period. A total of 2,095 of them received hospice care. Survival was measured as the time to death after a defined "indicative date" of the beginning of the terminal stage of illness.

The team reports in the Journal of Pain and Symptom Management that hospice patients lived an average of 29 days longer than non-hospice patients.

"Hospice professionals have often seen patients improve after admission to hospice care," Connor said. "We examined this phenomenon and found that in our study overall patients lived about a month longer while under hospice care."

Not all patients lived longer, but many did, "especially those with lung cancer and congestive heart failure, two of the most common causes of death in the US," he added.

In fact, patients with congestive heart failure nearing the end of life who chose hospice care survived an average of 402 days compared with 321 days for those who did not choose hospice -- a difference of 81 days.

Patients with lung cancer who chose hospice survived an average of 279 days compared with 240 days for matched patients who did not chose hospice, a difference of 39 days. For pancreatic cancer, the survival advantage with hospice was 21 days.

The difference in survival favoring hospice care was marginally significant for patients with colon cancer and not significantly different for patients with breast or prostate cancer.

This study shows that hospice does not hasten death but may actually yield extra time, which "might be particularly important to patients and their families, as it may allow some people to use the end of life as a time of resolution and closure," the researchers say.

SOURCE: Journal of Pain and Symptom Management, March 2007.

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