No one likes to contemplate their death, but it is something we all must face. For patients struggling with a terminal illness, hospice treatment offers many benefits. It can provide a chance to say goodbye to friends and family members, to recall a life well-lived, and to come to terms with things. Ultimately, it can be empowering, dignified, and compassionate.
However, the decision to begin hospice care is never an easy one. When is it time? How much more should caregivers take on in terms of caring for a terminally ill loved one? How much more time and money should be spent pursuing potential cures?
Hospice care can alleviate the stress on patients, on their loved ones, and on medical professionals tasked with trying to care for the individual. It can eventually become overwhelming. To determine if it’s time for hospice care, consider the following signs.
1. Do you make frequent trips to the emergency room?
Frequent trips to the ER even with curative treatments can be a sign that the patient’s condition is deteriorating rapidly.
2. Is treatment still working?
In most cases, even the most aggressive treatments will stop working eventually. If that is the case, then hospice care is the next step. This may also be the case if the patient no longer wishes to pursue aggressive (and potentially very painful) treatment options. Patients entering hospice often suffer from diseases like cancer, heart disease, lung disease, liver disease, HIV/AIDS, ALS, dementia-related conditions, and stroke that can become difficult or even impossible to treat in the long-term.
3. Have the symptoms become more difficult to manage?
As a patient’s condition worsens, their symptoms will also become more and more difficult to manage. This includes increased pain (and higher doses of pain medication), but it can also include many other symptoms, including nausea and vomiting, ulcers, and difficulty swallowing. Often, this degrades the patient’s quality of life significantly.
Many patients assume that hospice care is only designed for a few days or hours immediately preceding death, but that is not the case. In fact, hospice care can provide relief for patients up with up to six months of life expectancy. During those months, patients can receive compassionate, effective treatment for pain and discomfort, make informed decisions about treatments, communicate with family and friends, and enjoy a significantly better quality of life.
4. Do you need much more help than you once did?
Have you found that moving has become increasingly difficult? Perhaps you are now confined to a wheelchair. Maybe you’re unable to groom or bathe yourself and require someone else to help you or to do it for you. These can be signs that hospice care may be beneficial.
5. Are you withdrawing from daily life?
In some cases, terminal illnesses can result in patients withdrawing from their lives. Perhaps you’ve stopped doing activities you once loved. Maybe you find that you’re sleeping all the time, that you’re increasingly unable to stay alert, or that you’re struggling with mental confusion. Again, these may be signs that hospice care is needed.
Other signs include a reduced desire or willingness to eat, recurring infections, and a rapid decline in overall health even with aggressive medical treatments. If you or your loved one experience any of these symptoms, it may be time to consider hospice care.
The Conversation: What You Need to Know
Terminally ill patients must be able to discuss their wishes with family members and friends. If you have decided that it is time to move to hospice care, having the conversation can be daunting, but it doesn’t have to be impossible. Here are a few tips to make things easier:
- Don’t wait for the topic to come up naturally. Chances are good that it won’t.
- Make sure that your family members are aware of your wishes.
- Talk about your wishes often, and do so light-heartedly.
- Involve your loved ones in the planning, as much as possible.
- If necessary consider including a counselor in the discussion.
Questions to Answer Regarding Treatment
If you have received a prognosis of six months or less life expectancy and have decided that now is the time for hospice, it’s important to ask several critical questions.
1. Will your doctor support your decision to enter hospice care? Will they continue to be your primary care physician?
2. How will your pain and discomfort be handled?
3. Will pain management medication reduce your alertness or your ability to live your life?
4. Are there any non-pharmaceutical pain management options that can help?
5. What is most important to your quality of life during this time?
You are the only one who can decide when it is time for hospice care. If you have decided that time is now, choosing a compassionate hospice provider can help ensure dignity, comfort, and even joy in your life.