Hospice/End of Life
Erik Fromme, MD Oregon Health & Science University
Stages of Grief
Hospice Myths: Separating Fact From Fiction
There are many misconceptions about hospice. Some people associate calling on hospice with calling it quits. But hospice isn't about quitting; it's about facing one's death with dignity and comfort, surrounded by caring individuals. Hospice provides attentive medical, emotional, spiritual, and practical services for those with life-threatening illnesses, who most likely have six months or less to live. Their families also receive support services. Hospice doesn't hasten or prolong death, but makes sure the patient is as comfortable as possible while going through the normal process of dying.
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Some people think hospice only comes to the home. But hospice care is available at hospitals and skilled nursing facilities, as well as hospice houses.
Hospice is not always continuous. If a patient experiences a remission, hospice can be stopped and then restarted later when the patient's needs change again.
It Can Be a Difficult Call to Make
Hospice focuses on comfort treatment when curative treatment options have been exhausted or are not an option. That's why some physicians have difficulty recommending hospice. A doctor may feel he or she has failed the patient or will destroy the patient's hope. The decision to begin hospice is legally the patient's choice, but the doctor must sign a referral statement. If the doctor seems hesitant, it's important that you be an advocate for your parent's or loved one's wishes and talk with the doctor.
Core Hospice Services
Most hospices share a basic philosophy, but each organization is unique, so it's important to research several to see which is the best fit. All hospices provide the following services:
- An individualized care plan
- Bereavement counseling for the family for one year after patient's death
- A team of experts, which may include a physician, nurse, pharmacist, social worker, counselor, chaplain, massage therapist, volunteers, and more.
- 24 hour on-call services
- All levels of care
- Home health aides
- Spiritual and emotional counseling
- Medications, supplies and equipment
Tending With Deep Tenderness
Hospice care is more personalized and lenient than regular medical care. Family members can take a big part in caring for the patient. Hospice workers often go beyond the expected to meet patients' wishes and make them as comfortable as possible. In addition to medical attention and pain management, team members will provide companionship and spiritual or emotional care, depending on the needs and wants of the patient and family. They also provide respite care so the family caregiver can take a much-needed break. Regular family conferences help to keep everyone informed and give opportunities to discuss feelings about death and dying. The hospice team members will help deal with the practical but often painful details after the death, as well as guiding family members through the complex grieving process.