End of life is as natural as the beginning of life, but is nevertheless often laden with anxiety and trepidation. For patients being treated for terminal illnesses, the reality is frightening – but it needn’t be a painful experience. It is this aspect of death that hospices seek to alleviate, by providing services to generally terminal patients, and assistance to families grieving their inevitable loss.
The services provided by hospices typically take the form of “comfort care,” a method of medical treatment which focuses on alleviating both emotional and physical suffering for people who are in the final days of their lives as a result of age or illness.
An important distinction should be made about comfort care in that it is not necessarily a process that only terminal patients go through, but rather a method of treatment that can be taken up by anyone who desires to not be in pain and to not be alone as they undergo aggressive treatment to heal their maladies.
Hospice workers advise that families should feel comfortable in asking questions about the approaching deaths of their loved ones, initiating the conversations with their medical providers if necessary.
“Some doctors will hesitate to ask about a family’s stance on comfort care with terminal illnesses,” says Carolyn McGhey, a staff member at Grace Hospice. “Good doctors will talk about it all along.”
In addition to providing care for those suffering pain, hospices also provide noteworthy services to the families and friends of their patients, some for up to 13 months after the patient’s death. These services range from therapeutic counseling, to discussions with social workers and meetings with clergy members – services that are also provided to all hospice patients over the course of their care.
Overall, what hospices offer to terminal patients is an easing of pain, with meetings taking place frequently over individual needs, plans of care, medical regiments and the providing of medical equipment.
Similar services are also provided by institutions such as Clarehouse, which offers medical care and nursing in conjunction with hospice care as part of an end-of-life regimen.
“We work side by side with the hospice,” says Cheryl Martinez, clinical coordinator of Clarehouse.
Of the family-type care they offer, she says that Clarehouse “provides a break to families, so they can enjoy their last days with a loved one.”
An important consideration regarding hospice care is of course the cost.
“Medicare pays for a lot of hospice care,” says Jamie Webb, a nurse with Saint Francis Hospice in Tulsa. “There’s no out of pocket costs for the patients for issues related to their illness,” meaning that services provided directly related to an illness are not often charged to the family.
Hospices often take charity cases as well, she adds.
Aside from providing comfort care, terminal patients and their families also have legal considerations as they face a life’s end.
Such considerations are typically expressed by terminal patients with end-of-life advance directives, which convey their wishes in concrete legal terms.
“Basically, the living will is what I sign when I’m terminally ill,” says Andrew Wolov, an estate attorney with the Hall, Estil law firm. “It’s what I sign if someone else is going to need to make decisions for me.”
But the living will – officially known as an advance care directive – is not the only document important for end-of-life patients. There are also arrangements that can be made for wishes regarding organ donation and to legally designate health care proxies.