Does entering Hospice care mean death is near?

Bellababy asked...

My grandfather is 98 years old and we recently were told that he has cancer. Actually, the doctor said he has "a mass that is nearly blocking the entrance to his colon", a polyp on his kidney and liver and he keeps getting fluid in his lungs. Because of his age, and the fact that my grandfather didn't want this procedure... they did not take a biopsy which I suppose would tell them 100% if it was cancer? But they're saying 98% sure? Anyway there's nothing being done. Theyr'e going to begin sending Hospice over to the house. Does this mean that he's going to die real soon? He's not in any pain. His ankles get very swollen and he's wheezing a little louder. I'm me to understand.

Expert Answer

Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

Your grandfather's doctor has based his diagnosis on various tests and signs and symptoms that have presented during his course of treatment. From your description, there are many things going on that involve different systems of the body, such as the lungs, kidneys, liver and colon. Cancer is a disease that has a primary site, but can spread to other parts of the body; we call this metastasis. Sometimes, people don't even know they have cancer until it shows up in "another site".

When people have many disease processes going on, and cure is no longer an option, the best course is referring to hospice services. Hospice tries to concentrate on quality of life when quantity is no longer an option. We are about hope and support: hope to have pain and symptoms controlled, hope to deal with "unresolved issues", and hope to have some control over one's life. Your grandfather did not want any further procedures. This is his right to refuse such treatments and to die with as much dignity and respect as possible. It is our duty to respect that right, difficult as it can be for families. We are here to support your grandfather and you through this process.

Hospice care does not mean a person is going to die soon. However, people need to have a life expectancy of 6 months or less from a terminal condition, to qualify for our services. Hospice can help manage his symptoms"‚ÄĚsuch as the swelling in his ankles, and breathing concerns. At this point you can be glad he does not experience pain; and, you can embrace his desire to have a peaceful life closure, on "his terms".