Not ready to make reservation yet, but hospice nothing to fear

Newsroom humor tends to be dark, so heading off to see the $700,000 remodel of Nathan Adelson Hospice, I joked I was off to reserve a room for myself.

Seeing the cheery upgrades of Las Vegas' first in-patient hospice facility, built in 1983, it was hard not to imagine myself in a room years from now.

More than 44,000 people have been cared for by Nathan Adelson Hospice.

Today, there are 26 hospices in the valley and only two, including Nathan Adelson, are nonprofits.

Dying in peace is a business.

But it's also a philosophy: "No one should end the journey of life alone, afraid, or in pain."

Before Tuesday's annual open house, President and CEO Carole Fisher spoke with me about two of the worries families have about hospice.

■ Can families pressure hospice officials to overmedicate their loved ones, out of fear the patient is in pain?

■ Does pain medication hasten death?

Fisher said the hospice experts don't decide on medication because of family pressure but by what they observe in the patients. "We're still viewed as the experts," she said.

I've signed legal documents saying, even if pain medications hasten my death, give them to me if there's no hope of recovery. No feeding tube for me, thank you. My charts will carry a big "DO NOT RESUSCITATE." My family knows of my wishes because we've had our end of life discussions that so many families dodge.

Fisher shared with me a study published in 2006 and funded by the National Hospice and Palliative Care Organization. The study of 4,493 dying patients compared hospice and nonhospice patient survival among patients who died within a three-year window.

In a hospital, they're trying to save lives.

In hospice, the goal is to meet patients' and families' physical, social, spiritual and emotional needs.

The study concluded that instead of hastening death, as is widely believed, "The lives of some patients might actually be extended through the use of hospice care." The hospice patients lived an average of 29 days longer than the nonhospice patients with similar illnesses, the study concluded.

"First, patients who are already in a very weakened condition avoid the risks of overtreatment when they make the decision to enter hospice." This may be particularly true of cancer patients who decide against aggressive treatments such as high-dose chemo or bone marrow transplants where deaths rates are high.

Second, hospice may improve the monitoring and treatment patients receive, the study said, allowing patients medications that might not be covered by Medicare or other insurance.

"For people who are on the edge of survival, constant attention to their emotional well-being and physical health may increase their desire to continue living," the study said. "Without hospice, patients may feel that they are a burden to their family."

For those who haven't seen the remodeling work but are familiar with the inpatient facility at 4141 Swenson Street, the aviary is now a conference room. The large central courtyard that used to be desert landscaping is now green. The floors are new hardwood and tile. New furniture and periwinkle blue paint in the rooms created a fresh, cheery atmosphere.

Last month, Modern Healthcare named Nathan Adelson one of the 100 "Best Places to Work in Healthcare for 2010." The hospice was the only Nevada organization to make the list.

Glancing into a room with a patient, it's still obvious this is a place for dying. The average stay is three to seven days, just about the length of a getaway vacation, except the getaway is permanent.

Not ready to make my reservation yet, but I've learned not to be afraid of hospice. I'll be telling that story on Thanksgiving.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.