Hospice care should not be worth fear or sadness. When Kath Murray tells people what she does for a living, there’s always an awkward silence, a sympathetic tilt of the head, and the inevitable reply, “That must be hard.”
“Never has a job made me smile so hard,” said Murray, a hospice nurse and palliative care educator in British Columbia. “The reality is unbelievable.”
It’s not what most of us imagine, and that’s exactly the problem.
Murray founded Life and Death Matters in 2005 to help health care workers caring for the dying. The organization continues to grow and provide resources to nursing students, long-term care facility staff and families as they care for the dying.
Murray said there’s a big misconception that prevents families from getting care when they need it most: People think hospice means giving up.
“That’s the biggest myth,” Murray said. “But we’re actually good at holding onto hope and reality at the same time.” Hospice is about living better, not giving up on it entirely.
What is hospice care?
Many people often think of palliative care and hospice as the same thing. Palliative care can begin with diagnosis and integrate treatment, symptom management, and improving quality of life.
Hospice care is reserved for terminally ill people who typically have six months or less to live. It provides comprehensive comfort care to patients and their families.
Both types of care are designed to help you live better, not worse.
People typically enter hospice with less than six months to live. (Image via Getty Images)
Murray’s close encounters with the dying allowed her to witness and learn from those who faced and accepted death.
“I learned from people who had time to think about what’s really important in life. It was never about luxury cars or designer brands,” she said. The work taught her something unexpected: a deep appreciation for everyday life. “I remember coming off work one rainy day and feeling so grateful that my arms and legs still worked.”
When should families consider hospice care?
When daily life becomes difficult, most families begin to consider hospice care. Maybe someone is unable to bathe or cook for themselves. In some cases, their health becomes unpredictable and they end up in scary emergency rooms after good days.
Sometimes it becomes clear that the support needed at home exceeds what the family can provide. Physical decline is a sign that something needs to change.
“It’s never too early to have these conversations,” Murray said. “It’s not just cancer: we’re also helping treat heart disease, COPD, dementia and diabetes.”
Unfortunately, access to hospice services varies across Canada, depending on where you live and provincial funding levels. Most hospices rely on volunteers to offset the cost of providing care to those in need.
One of my patients told me, “It’s not death that scares me…it’s the dying part.”
When a patient enters a hospice care center, it can be a little unsettling. Additionally, many people worry that this will be a painful process.
Hospice care can include pain management options for patients. (Image via Getty Images)
“One patient told me, ‘It’s not death that scares me…it’s the dying part,'” Murray recalled.
Many hospice providers can help manage pain and discomfort with medications, but there is an additional factor of emotional suffering.
Death doesn’t look like it does in the movies, but hospice teams often include counselors to help patients and families understand the dying process and help them prepare for the future. Murray said only a small percentage of people will enter hospice and experience a steady decline in health until death; the rest will go through what she calls a “roller coaster.”
“The family gathers to say goodbye, and all of a sudden, this person picks himself up and says, ‘I’m not going anywhere.'” Murray explained, adding that it can be emotionally draining for the family.
how to help someone
People often wonder how they can support families who have a loved one in hospice. Death can be an uncomfortable topic, especially for those who have not yet experienced a significant loss. Also asking, “How can I help?” may be well-intentioned, but it doesn’t alleviate any stress or pain they may be experiencing.
Rather than asking a vague question, try to be specific about how you can help. Some examples include:
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“I’ll bring dinner on Tuesday.”
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“Can I go grocery shopping this week?”
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“I’m free to drive my kids to school.”
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“Here’s what I can do…what would be most helpful?”
These statements and questions can help resolve the issue without creating more work for your friend or loved one.
Be specific when offering to help a friend who is receiving hospice care. (Image via Getty Images)
What should be said and what should not be said
When you visit someone who is seriously ill, words matter more than you think. Phrases meant to be comforting can actually make things more complicated. Instead of saying something like this:
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“everything happens for a reason.”
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“They’re in a better place now.”
You can provide support by:
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Ask them what they want to talk about
Sometimes they want to talk about their illness, sometimes they want to talk about anything but that.
“The most important thing? Follow their lead,” Murray said. “Sometimes they want to talk about their disease, and sometimes they want to talk about anything other than that.”
Accept support
Hospice is not about giving up hope. It’s about making the most of the dignity, support, and time you have with your family.
It’s about focusing on what matters most when time is precious. It’s about having honest conversations, creating meaningful moments, and sometimes finding more laughter and joy than anyone expected.
The goal is not to hasten death or to forego all treatment. It’s about living life to the fullest possible while facing reality with courage and the right support.
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