End of Life: Quality or Quantity?

By John W. Middleton, M.D.

Over my career as a family practice doctor, many aging patients have asked me how to prepare for the end of life. It is my belief that we must always ready ourselves for the end of our lives. We must first recognize our own mortality. Everyone, including me, will continue to grow older; with age comes chronic conditions, serious medical issues and sometimes terminal diagnoses.

Modern medicine advances continue to treat and cure illnesses, but every disease follows a somewhat predictable course, and medicine has its limitations. Understanding the progression of a disease, treatment options available and expected prognosis is paramount. Often, precious time is spent on treatments that, ultimately, won’t benefit the patient or change his or her condition.

Two options that many might be unaware of are palliative care and hospice care and the distinction between the two. Palliative care focuses on relief from symptoms and can be used during treatment. Hospice care also focuses on comfort of the patient and relief of symptoms but is for patients who have stopped curative treatment and have a prognosis of 6 months or less. The decision to use palliative care or hospice care is difficult to make and should involve the patient, family and care team.

I often caution patients that undergoing treatment may only prolong life and decrease quality of life. It has always been my philosophy that quality of life is more important than quantity of life. That’s not to say that I don’t want my patients to live long, fulfilling lives, but that I want them to enjoy every second available, making the most of their lives. At Carroll Hospice, we want to maximize our patients’ lives. Death is an inevitability, but we want to make every moment count.

Dr. Middleton is the medical director at Carroll Hospice.

2 thoughts to “End of Life: Quality or Quantity?”

  1. My husband & I believe in quality, not quantity. When he was diagnosed with lung cancer, and told 3 months or with Chemo MAYBE 6 months, but it wouldn’t be quality. As difficult as this decision was, he choose quality. He lived 2 weeks. It has been 3 years now that I lost my love. Everyday it still hurts. Our Nurse Lucinda is my Angel. She went beyond her call to ease my husband’s discomfort and to give love & comfort to me, my daughter & grand daughter. Thank goodness for the caring community of Hospice .

    1. Thank you for sharing your thoughts and experience surrounding the loss of your husband, Barb. Carroll Hospice has a Widow and Widowers Support Group that meets the first Tuesday of each month at Dove House from 6:30 to 8 p.m. if you’d like to attend. No registration is required. Please call 410-871-8000 for more information. We’ll also pass along your kind words to Lucinda!

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