Serious content alert. I know, I usually go for light-hearted or at least poignant, but a Tweet about a hospice volunteer caught my attention the other day. That brought to mind doing a post for those who might not be familiar with hospice. Perhaps you will never be in a position to need that service, but it is good to know about it. I was only vaguely familiar with hospice when I was with my former mother-in-law during the last months of her life. Like many people I spoke with later, I associated hospice with cancer patients. That is correct, but the actual criteria for hospice care is that an individual be declared by a physician to be terminal, and that can be any medical condition. Although the “terminal” aspect is considered to be six months or less, that is not a hard-and-fast definition, and some patients do actually recover. Despite the fact that my former mother-in-law was only under hospice care for a week, I learned a great deal and devoted a chapter of Your Room at the End: Thoughts About Aging We’d Rather Avoid to explaining more about this approach to end-of-life care.
The essentials though are that there is no hospice with a capital “H”, per se. Each Hospice group is organized independently, adhering to the same principals and abiding by the local state rules for medical care. Some hospices are associated with religious groups and others are not. Some offer a paid service of nurses and nurses assistants for on-site 24-hour care, but not all do. Three important things to know about hospice are that: (1) the individual must have made the decision to cease medical solutions other than for pain management and comfort. In other words, if an individual continues to take treatment or medication that is intended to battle a disease/condition, the individual is not eligible for hospice. I know, it runs contrary to what we usually do and that is why the decision to enter hospice can be so difficult – sometimes more so for the loved ones that for the individual. (2) An individual can still be in a hospital or other care facility because there may not be a suitable “home” to go to, or the individual might require something like artificial feeding. The artifical feeding is for comfort, not to combat the underlying disease/condition. In this case, the hospice “team” takes over certain functions while the hospital/facilty staff continues with others. (3) Entering hospice care does not mean someone is “giving up”. What it means is that an individual acknowledges that he/she is in a terminal state and no longer wishes to undergo invasive procedures and may prefer to be at home for their final months, weeks, or days. It is a time for family and friends to make their farewells.
This synopsis about hospice is greatly simplified and if you have aging parents, other relatives, or friends, I urge you to read more about hopsice. No, it isn’t a pleasant subject, yet I will tell you from experience that it can a wonderful source of support at what will be a very emotional time.