Senior Center

When Hospice Care Becomes the Next Step

By Jan Bolder - January 15, 2014

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Seniors who are seriously or terminally ill may wish to choose hospice care so they can die in comfort and peace, and generally applies to those who have six months or less to live. But is it for everyone?

What Is Hospice Care? Everyone dies, but some will have that process rapidly accelerated, such as those with cancer. And when treatment becomes ineffective, the medical focus shifts from curing to relieving symptoms and does away with life-saving measures or hospitalizations. Instead, the patient will be given medications and other treatments that make them more comfortable instead of trying to eliminate the root problem.

Who's Involved? For a person to begin hospice care, two physicians must sign off that the patient has a medical condition which will result in death within six months. After that, the hospice care team can include anyone who can help to make the patient's life more comfortable, ranging from homecare nurses and in-home doctor visits to psychologists, spiritual leaders and social workers.

What Happens? Each hospice care plan differs on a patient-to-patient basis, with a specialized approach drawn up that best serves the person's physical, emotional and psychological needs. For example, a person with ALS can can have a variety of difficult-to-manage symptoms, such as difficulty speaking, swallowing, chewing and moving, and their hospice plans needs to take that into account. If eating and drinking water start to interfere with their quality of life, hospice care can treat the side effects of not maintaining nutritional intake.

Are There Any Tests or Procedures That Still Happen? Generally, no. The aim of hospice care is to relieve symptoms, not to find out what's causing them and remove them that way. And because analgesics can be applied to a variety of symptoms (e.g. morphine), the doctor may determine that administering a test or procedure would only cause the patient more harm than good.

What Is It Like For The Patient? Ideally, pain-free, although that's not always the case. But the goal should be the patient feels more comfortable with symptom-relieving treatment than they would with the side effects of disease-curing treatment. As they get closer to death, though, their mental status may change dramatically and they can become increasingly less aware of their surroundings. 

What Role Does The Caregiver Play? Just to be there for the patient. The next several months are about them and their comfort, but it's important that caregivers don't neglect their own health, too. Talking to a psychologist or social worker can help ease the burden- and caring for a dying person can be quite difficult to shoulder- to ensure that everyone goes through the process as best they can.

What Are The Disadvantages? There are several: a doctor may not always be on hand (such as if a patient suffers a heart attack); care can become incredibly stressful; there's no guarantee the patient will "click" with the hospice care team (especially a concern for people with dementia); and it can force family members to accept an imminent death over which they have no control.

Hospice care can be the right choice for a lot of families, and not so for others. Before committing to it, it can help to talk to a medical professional team well-versed in hospice care, as well as other families or friends who have experience with it.