I’ve written many times about my neighbor, and dear family friend, who had been fighting lung cancer that spread. He lost his battle against that disease about 2 weeks ago.
I am sad that he is gone. He was witty and irreverent. He knew how to give a dinner party. He was an amazing cook. I have never known anyone who could make decent French baguettes from scratch. He did, and he did it all the time, as if it were as easy as pouring a bowl of cereal. He could make piano keys smoke, and played Beethoven concertos well into his illness.
I am sad to lose him, but I am happy about this: His dying was made as comfortable as it could be. Why was that? He had hospice care.
Here are some of the many, many ways hospice eased his passing:
He had lung cancer, so breathing became an issue a few months ago. Hospice made sure he had a supply of oxygen tanks and a refilling device at home.
His bowels became seriously plugged up — as so often happens in terminal illness. Hospice treated that for him at home, saving him from going to a hospital for the procedure.
His partner of 52 years was recovering from a recent hip replacement, so hospice workers took care of the heavy lifting, literally. Hospice workers walked their little terrier dog. They took care of bringing in the groceries, up three flights of stairs. They did light cleaning, or as much as was possible in his house crammed with art and books and knick-knacks. Hospice even bathed his ill partner.
When the end came close, they made sure my friend had meds to ease his distress and anxiety.
Hospice eased his way.
The majority of patients only take advantage of hospice in the final few weeks of life. But it’s really appropriate as many as 6 months before death. Choosing hospice doesn’t mean giving up — it means shifting the priority from cure to comfort.
There are many subtle differences between hospice providers. Some providers have a large staff, including nurses, doctors, chaplains, social workers, and grief counselors; others are smaller. Some provide care at home. Some hospice centers are residential facilities.
Consider these things when you’re choosing a hospice:
• What services does it offer?
• How does it coordinate with the patient’s medical team?
• What, specifically, will it do to make the patient more comfortable?
• If the hospice uses volunteers to provide some services, how do the volunteers and professional staff define their roles?
• Will the hospice provide services after hours?
• If the patient prefers to stay at home, will the hospice provide short-term inpatient care?
• How does it make sure that the patient’s wishes — such as an advance health care directive — are honored?
The National Hospice and Palliative Care Organization, has a web site that will help you find a hospice provider anywhere in the country.
You can also get referrals to hospice providers from your local chapter of the American Cancer Society, the local Agency on Aging, a local United Way chapter, or the Visiting Nurse Association of America. Your place of worship may also have information on local hospice options. Check the blue pages of your local phone book, or the web site of your state government, to see which hospice options are covered by Medicare or Medicaid.
If your medical team has said your prognosis is 6 months or less, consider hospice. It’s not about dying — it’s about how you choose to live in those last months. When my turn comes — if I’ve got some notice that the end is approaching — I’m calling hospice to ease my way.