Tuesday, August 17, 2004

When Will We Be Ready for Hospice?

Patients with terminal illnesses and their families are eventually faced with this decision. When do we stop trying to cure the disease? When will I be ready to turn to hospice? Some people view hospice as giving up hope and as throwing in the towel. In their minds, hospice equals death and the end. Sometimes people keep hoping and praying for a cure right up until death comes and takes them or their loved one whether they are ready or not. I do not make judgements against people who go this route. We are all in this life, on a journey, trying to figure things out. We are all doing the best we can with our given resources. And everyone makes different decisions for different reasons. I have been moved to tears by couples grappling with this decision. It is not an easy decision to make. No one wants to let go.

To these people, however, I try to explain a few things in order to help them make an informed decision:

1) No one is telling you that you must give up hope in order to start hospice. Some people graduate from hospice. Some people outlive all expectations and test results suddenly look different and they get discharged - still alive - from hospice.

2) Hospice doesn't equal death. Hospice means shifting focus away from cure and onto improving quality of life. If efforts to lengthen someone's life seem to be causing more detriment to the individual and to the family with a minimal expected return, the shift may seem natural (painful nevertheless, but appropriate) to refocus on comfort measures.

3) Suggesting hospice does not mean that you don't love your family or the loved one who is ill. You are not saying "I am ready to die" or "I am ready for you to die." Considering this option means that you accept that the Western medicine treatments that are currently available are not going to cure the disease and that you do not want to continue to suffer or to watch your loved one suffer.

Anyone who is expected to live six months or less is eligible for hospice. And the sooner hospice is initiated, the more both the person who is dying and the family will benefit. Many people continue to pursue potentially life-saving healing practices in complementary medicine such as Traditional Chinese Medicine (TCM), Qigong, guided imagery, acupuncture, etc. (See new Complementary Medicine links in my sidebar). By initiating hospice, however, you are agreeing to cease all Western medicine efforts focused on cure.

Honestly, I think we should all be in hospice in a certain sense. Our medical care should always have a strong focus on comfort and relief from pain and bothersome symptoms, a focus on mental health and emotional well-being.

1 comment:

Hospital Chaplain said...

"By initiating hospice, however, you are agreeing to cease all Western medicine efforts focused on cure."

Please note that in 2010 (or earlier?), a significant change was made in United States hospice regulations so that it is no longer necessary to cease *all* Western medicine efforts to go onto hospice service. For more info, please check with your local hospice(s).

(I realize this may have been addressed in a more recent post, but wanted to make this clear on this one. Thanks for this wonderful blog!)