Health Affairs Narrative Matters

Listen to Krista Lyn Harrison from the University of California San Francisco read her essay about hospice care and how the model fails when patients die more slowly than expected.

Show Notes

Hospice care is meant to optimize quality of life and minimize sources of distress at the end of life. In theory, enrollees are entitled to an unlimited number of days of hospice care, though they have to be recertified after 6 months. But in practice, some patients end up discharged alive rather than re-enrolled.

In this episode of the Narrative Matters podcast, Health Affairs’ Jessica Bylander talks to Krista Lyn Harrison, an assistant professor of geriatrics and health policy at the University of California San Francisco. In this month’s essay, Harrison writes about her stepfather’s experience with the hospice care system at the end of his life, and how the model ultimately failed their family and how it fails other patients who die more slowly than expected. After being discharged alive from hospice, Harrison’s stepfather’s health soon declined again and he died nearly eight months after his initial hospice admission.  

Harrison, a former hospice administrator, says she has the utmost respect for her hospice clinical colleagues, but that the hospice system is not quite keeping up with what’s best for patients and families. Hospice, or its alternative, should better support different disease trajectories and functional needs for patients who are dying, she says.

Following the interview, Harrison reads her essay “The Hidden Curriculum Of Hospice: Die Fast, Not Slow.”

This podcast is part of Health Affairs' Age-Friendly Health series, with support The John A. Hartford Foundation.

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What is Health Affairs Narrative Matters?

Personal essays from the front lines of care