When It Shifts: Lessons Learned from a (Not Always Patient) Nurse Turned Patient


For the past year and a half, I’ve been spending time with a friend on hospice. You read that right. To qualify for hospice, prevailing medical opinion must be that a person has only about six months to live. That can be a difficult prognosis for a patient, and a patient’s family and friends, to accept (even a physician may resist acknowledging that it’s time to think about end-of-life care rather than persisting in aggressive treatment). But, paradoxically, accepting that death is a reality can improve both quality and quantity of life. Numerous studies suggest that the earlier a person opts for hospice, the longer they live, and the better the experience they have in their final months. Although there are some excellent hospice facilities in communities across the US, and increasingly around the world, people on hospice may also be able to remain at home, which can further improve both quantity and quality of life.

This has proven true for my friend. Perhaps her career as a nurse allowed her to understand the implications of all the choices she made as a patient—pursuing new treatments when the lung disease she had progressed, then transitioning to hospice when it became clear those new treatments had come too late to slow her illness. She’s remained active as long as she could in whatever way she could. And she’s been able to live her life at home, surrounded by her spouse, her dog, her musical instruments and art, and as many visitors as she could put up with, whenever she wanted to see us. I’ve learned a tremendous amount from sharing this time with her and her spouse, and it’s shaped my thinking, teaching, and writing about illness and the end of life. “When It Shifts,” a short post about an incident early in her time on hospice, just appeared in Oregon Humanities magazine. You can read it here.

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