Elizabeth Edwards and Her Final Days in Hospice Care

Elizabeth Edwards knew this day was coming, and she planned for it by embracing the life she had remaining while also preparing for the inevitable. Her husband's presidential campaign had ended, and along with it, the lifeline that Elizabeth had clung to when she first got the news that her cancer had returned in early '07.

Some commentators thought that John Edwards should have dropped out of the race knowing what his wife faced, but Elizabeth wanted him to stay and campaigned for him as though her life depended on it, and maybe it did. As long as he was in the running, the hard choices about his infidelity and the terminal nature of her illness could be set aside for what she must have believed was the greater good -- getting her husband to the White House.

He was at her bedside as cancer took its final toll, and with the help of hospice, those who loved and admired Elizabeth can only hope these two long-married people found some solace in each other. Hospice has been called the best health care nobody wants because it signals the end of life. The average stay in hospice is just two weeks, though it is available to anyone with a life expectancy of six months or less. Elizabeth had long been an advocate of hospice, and in 2009 the National Hospice and Palliative Care Organization (NHPCO) named her their person of the year. Full disclosure: I'm on the board of the National Hospice Foundation, which I joined after my husband died at home with hospice in 2005.

The experience made me a believer. Tom had endured all kinds of draconian treatments. When those treatments were exhausted, and the cancer was advancing, his oncologist suggested hospice. I remember being upset at first because I knew it was the end of the road, but it was time, and for someone whose death is inevitable and imminent, spending those last days at home is the gift that hospice offers. Its holistic approach to health care provides counseling along with pain medication.

The fact that John Edwards was there with his estranged wife in her home in North Carolina is a very good thing. Despite all the sordid stories we've read about him, these two people had a long life together, and many hardships. The death of their 16-year-old son Wade in a car accident is the kind of loss that can destroy a marriage. I was reminded of that over the weekend when I saw "Rabbit Hole," a searing drama starring Nicole Kidman about a couple coping with the senseless death of their 4-year-old hit by a car while chasing the family dog.

Their time in hospice, brief as it was, allowed the Edwards family – Elizabeth and John, and their grown daughter Cate – to re-visit old wounds along with the new ones that ended their marriage. Seeing a loved one on his or her death bed tends to focus the mind, and for Elizabeth, who was courageous and clear-eyed all along about the progress of her disease, hospice gave her and her estranged husband a chance to heal those wounds, forgive each other, and sort out what they want for their children, Emma Claire and Jack, who are very young.

Elizabeth was a champion of hospice, both the comfort it brings and the reality that it helped her face. She put it best in a statement meant for hospice and palliative care workers in the fall of '08 when she said, "Throughout my life, both personally and professionally, I have had the opportunity to see how people have been affected by illness and loss and the role the healthcare system may have played as they dealt with change in their lives. I also know that people can find a great deal of hope, even in the most challenging of life's situations. Hospice and palliative care professionals support and care for people at a time when hope can be hard to find. The professionals of NHPCO know more than I will ever know about providing that care; I know more than I wish I knew about receiving it, and I am happy to share my perspective with them."