HOSPICE IS YOUR FRIEND

In the old days, hospice was a place where people went to be tended through their final days: a place to die (actually, in the really old days it was a refuge for travellers, nothing to do with dying). Nowadays, hospice is a service, not a place, but it still tends to people in their last days, trying to make that time as comfortable and pleasant as possible.

Hospice is for people who have a terminal illness, and who, their doctors believe, have a life expectancy of six months or less (this is important, as the doctor has to certify to this belief—they can’t admit just anyone to hospice). The patient has to have decided that he will no longer seek a cure for the illness, but only “palliative” care (care that reduces symptoms). The service generally consists of a nurse, a social worker, a home health aide, and a chaplain. There is also a medical director or doctor who serves as a resource.

The nurse comes to the patient, first to do an assessment, and then regularly, depending on how often the patient needs to be seen. Toward the end, the nurse comes more often, even daily. Sometimes the hospice agency will provide a nurse to stay 24/7. To cover the times in between nurse visits, the hospice nurse teaches the family how and when to administer the various comfort medications that have been prescribed. The family also may call the hospice at any time for advice, or if something changes.

The home health aide will come in and bathe the patient, and help the family with personal care. Maybe she will do a little back massage, or help the family with laundry. The social worker makes sure both the patient and the family are managing with their feelings about the terminal illness. She is available to the family even for a time after the death. She also helps with things like funeral arrangements, and calling family members who live far away. The chaplain is generally non-denominational and provides spiritual support if the patient desires it. Sometimes the patient prefers to have his or her own priest or rabbi or other spiritual advisor, and that’s fine.

Many people think that hospice shortens lives. Some even think that putting someone on hospice is a way to hasten that person’s death, as in “Mom’s quality of life isn’t good any more. Let’s put her on hospice.” But this isn’t the case. Hospice is so successful in improving the quality of a patient’s life, that in studies it has actually been shown to prolong life by a few months compared with similar patients who were not put on hospice.

Hospice is a wonderful friend to a dying person, and to the family. Please talk to your doctor if you or a family member have a terminal diagnosis and are not enrolled in hospice.