Most people have heard of Hospice, the service that works to accompany end of life with dignity and without pain. Unfortunately this incredible organization is often as misunderstood as it is under-appreciated. This article will try to help improve that situation.
Hospice is a philosophy of care which focuses on the palliation of (to cloak, conceal, and relieve) the symptoms of terminally ill patients. The term and its implementation goes back to the middle ages, when sometimes the terminally ill were brought into churches and cared for there. Some say the first hospices date to the Crusades, although the first dedicated hospice was thought to be in Rhodes in the 14th Century. The focus in hospice is not to cure the disease, but instead to help the patient and his/her family meet death with dignity and in comfort.
Most patients receive hospice care in their homes, although many others receive this important care in hospitals, prisons, and dedicated hospice facilities. Most hospices are non-profits, but almost all receive financial support from Medicare. Wikipedia states that In 2005 more than 1.2 million individuals and their families received hospice care in the U.S. Many people who are nearing the end of their lives are not aware they might qualify for valuable hospice support. Hospice is generally available when death is expected within 6 months. However, if a loved one faces an inevitable decline longer than that, with a doctor's certificate hospice services might be available to make the patient and family more comfortable.
Hospice provides a wide variety of services both within and outside the home. Their chaplains are highly trained professionals who provide valuable counseling and a sympathetic ear to both patient and family. Many volunteers are available to provide conversation, patient-sitting, pet therapy, and other services. Hospice doctors and nurses can help evaluate a patient's medical condition and provide care recommendations - usually with the point of view of helping the patient cope with pain and symptoms, rather than a cure. Hospice social workers are a valuable advisor in end of life situations. They will help families determine when it is time to begin pain medication and/or withdraw from medical treatments.
Hospice and its palliative care approach offers a radically different contrast to the curative approach of the traditional medical establishment. Whereas doctors and nurses for the general population are trained to look endlessly to find a cure for the patient, Hospice professionals recognize that such radical interventions for the terminally ill are usually unproductive and painful. Last-minute surgeries and medications at the end of life are not only dangerous, but disrupt the remaining quality of life.
Side Note - A Personal Perspective
My 92 year old father recently was told that the end of his life was approaching. A failing heart (cardiomyopathy) was his major problem, and his cardiologist informed us that there was no cure. Within a year of that diagnosis things went poorly for dad. He became weak, tired, and depressed about being sick (he was a legend for his "Energizer Bunny" ways). He was in great pain in his joints and slept very poorly. Tremendous nightmares kept him and my mother awake all night.
At that point my wife suggested that perhaps Hospice could help; my mother agreed and Hospice accepted him as a patient. The impact of that decision was immediately profound. Chaplains, nurses, doctors, physical therapists, aides, and volunteers came to their apartment to care for him. Everyone was grateful. Then my father took a turn for the worse. An evaluation concluded he had only days or hours to live. He was moved to a nearby Hospice facility where the most highly trained and skilled professionals imaginable cared for him and our family. They helped us see dad pass into the next world relieved of his pain, all the while providing support and advice in a beautiful facility.
As only one example of the quality and depth of their care, here is what happened when the end came for my father. The staff asked us to leave for a few moments where they prepared him for us to see him. When we returned dad was there for us to see, all but his face and hands covered with a quilt hand-made by loving volunteers. There were flowers, a candle burning, and the Bible open to the 23rd psalm. It could not have been more beautiful or peaceful. My siblings and I could only think what would have happened to dad if he had gone into the emergency room in his last days. Poking, prodding, invasive treatments, ringing bells, and short-staffed - the contrast is too frightening to think of. Thank you Hospice!
For Further Reference:
About Hospice & FAQs
Hospice Foundation of America