Can illness narratives contribute to the delay of hospice admission?

Abstract

Patients who could benefit from the end-of-life care that hospice provides frequently underuse this service because their admission occurs very late in the course of their dying. Admission to hospice requires that patients and their physicians shift their treatment goals from cure to comfort care. However, this shift is not likely to occur unless there is a parallel shift of hope, from hope for a cure to hope for the best possible quality of life. This study considers how a prominent type of illness narrative, the restitution narrative, delays decisions for hospice by inhibiting the transformation of hope from a hope for cure to a hope for quality at life’s end.