Why do people wait till the end to choose hospice? May seem like a silly question given that hospice IS for the end, but, what is the time factor for the end? Six months, one month, two weeks, a few days? Medicare’s allowance for hospice is when there exists the likelihood that a person has less than six months to live. Of course, this prediction can be “outlived” and hospice services can continue beyond six months, given all other Medicare required criteria exist. (Note: Other insurers use Medicare guidelines for hospice criteria as well to benefit younger, non-Medicare patients.)
But what we see in hospice all too often is not that people are on hospice for too long – but rather, for too short a time. So many people don’t take advantage of hospice benefits at what potentially may be the sixth-month marker. Or at four months. Or for some, even at one month. They, and/or their doctors and/or their families may not consider hospice until the final days. And what a shame. They miss the benefits of a holistic experience that can enhance their physical, emotional and spiritual well-beings.
Hospice is not about surrendering or throwing in the towel. Yet, that is how many see it. “I still want to fight; I’m not ready to let go,” is a common cry. But hospice isn’t saying throw in the towel and give up and let go. To the contrary, hospice invites patients to share their goals, their hopes, and their wishes. And from there come the hospice team’s objectives: to try to help patients fulfill what they can in the time that they have. In essence, hospice is about living life to its fullest. Far from giving up and letting go.
Hospice is not about giving up hope. Many hospice patients tell us at NVNA and Hospice and at our Pat Roche Hospice Home that being in hospice enabled them to come to peace with things in their lives that they had yet to resolve; to make the time to be with people that mattered to them; and to complete goals they had. All pieces of life they hoped to fulfill.
Hospice is not just for the patient. Families and loved ones benefit from hospice in many ways. The hospice team works with the family to ensure they understand their loved one’s disease process and helps guide them towards what they could expect as that disease progresses. The chaplain is available to provide spiritual support for all, regardless of religious affiliation. A social worker can offer resources, advice or a caring ear to help with the psychosocial and emotional aspects, and bereavement services are offered during and after hospice care. Just as hospice encompasses the whole aspect of the patient’s life, so too it includes the whole family.
When we see a patient who is ready for hospice but his/her family is not, there is such conflict for all. It’s so important for families to understand the benefits of hospice: how hospice can enhance their loved one’s and their own lives. And to realize that hospice will not accelerate one’s death but can often extend one’s life by providing quality and clinical attention that best meets the patient’s needs.
Knowing and appreciating what a loved one wants when facing a life-threatening illness or disease makes all the difference. Talk to each other; learn about each other’s wishes; share concerns and hopes. Honoring Choices is a great place to start and as its name states, it’s one of the greatest gifts loved ones can give each other.