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DOCUMENTS


The Tentacle


June 26, 2008

Hospice and Palliative Care

Patricia A. Kelly

Oh, no! Not Hospice! Get out of my room. I’m not dying!

 

There stands the Hospice nurse, or the Palliative Care nurse, her face undoubtedly a grinning skull, her body undoubtedly covered by a long, black cape.

 

Let either one of them into your life and you immediately become either irrelevant, or dead. And I mean right away.

 

It’s sad, really, that so many very ill people join or check into Hospice in the very last days of life. They live three more days, or something like that, and then die without having the opportunity to enjoy the benefits.

 

The truth about Hospice is that it is generally for people who realize their illness is likely terminal, and who might be likely to die of that illness within six months. Although people signing up have generally given up the idea of seeking a cure, and are primarily seeking comfort measures, their treatment may include such palliative treatments as radiation or blood transfusions that give them relief from suffering, but could also help their condition. Most important, they get comfort and symptom control.

 

Some people in the Hospice program live a very long time and have a high quality life.

 

People have access to care across the spectrum, and people have been kicked out for surviving. It’s okay to graduate!

 

Palliative Care, defined as “relieving or soothing the symptoms of a disease or disorder without effecting a cure,” is usually initiated prior to entry into Hospice, when really long term survival is not very likely. Strong emphasis is placed on symptom control, comfort and quality of life.

 

Palliative Care programs are being developed in many hospitals across the country. I wish they were everywhere. Patients experience powerful therapies to control symptoms, but may continue seeking a cure for any illness they are facing. Who in his right mind wouldn’t want that? As far as I’m concerned, everyone needs it!

 

It’s actually quite amazing what is out there for symptom control. If you have pain, it can almost always be controlled. If you have a lot of secretions, or cough, there are medicines for that. Your bed could be arranged for greater comfort. Your wishes about who can hang out with you would be respected.

 

What’s not to like about this?

 

My experience with palliative care left me awestricken. I personally helped someone get rid of the famous “death rattle” by informing the treating doctors what could be given to control it. I’m still happy that she and her family were given the peace of not having to listen to that as she lay dying.

 

Since most high tech care is spent on those who are near the end of their lives, entering more people into Hospice would save hospital costs, too, although that isn’t nearly as important as the personal benefit that patients get.

 

What would you rather do? Die tethered to a machine with your arms restrained so you can’t pull out your breathing tube? Or would you prefer to be under a warm blanket holding the hand of someone you love, maybe in your own bed at home?

 



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