Why Sparky Anderson’s death occurred so soon after he went to hospice.

George "Sparky" Anderson (1934-2010)

Hall of Fame baseball manager Sparky Anderson’s death was announced less than 24 hours after a previous news item revealed that his family had moved him to hospice.

Baseball fans across the U.S. are saddened by the loss of the first manager to win World Series championships in both leagues (Tony LaRussa is the other); many are likely puzzled as to why his death came so closely on the heels of his family’s announcement about hospice.

Among patients, hospice in the U.S. has mixed connotations; some view it as the desirable way to make a final exit, others perceive the very word pejoratively as coded language for ‘giving up all hope.’

The modern hospice movement can be traced back to Dame Cicely Saunders, who founded St. Christopher’s Hospice in London in the mid-1960s. With her nursing background, Dame Saunders’ experiences led her to formulate the principles of palliative care: alleviating pain and suffering to the the maximal extent possible, with the ultimate promise of bringing dignity to the dying.

The difficult part for a patient like Anderson, his family, and his doctors is deciding when to initiate the referral to hospice. Making the decision is a gradual process, the key part of which is reaching acceptance of imminent death. Obviously, many patients and their families never reach this stage.

In order to qualify for hospice, a patient must have a terminal diagnosis, defined as six months or fewer of remaining life. This is fairly straightforward with cancer diagnoses, which are staged precisely and tend to move along predictable trajectories. Prognosis is much more challenging for patients in the end stages of chronic diseases like congestive heart failure, emphysema, and dementia, which is the condition that Anderson was reported to have.

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