We have heard doctors declare, “There’s nothing more we can do.” They mean no cures remain, no procedures to stop the disease progression, no cutting-edge experimental drugs to make a difference.
It is a time to shift from curative to comfort care.
Hospice is not about giving up.Since hospice is a choice, and allows people to be at home and engage with the loved ones in their life, it is not about giving up. It is a choice to make the most of every precious day.
Talk to the doctor about end-of-life hopes or fears long before needing hospice care. If you’ve never openly talked with any doctor about end-of-life wishes, and are now facing a serious illness, you may need to start the discussion. Some doctors are comfortable talking about dying and death, but some aren’t. Never assume your doctor will start talking first.
Palliative care is about living
Hospice is designed to maximize time with family, to express and/or receive love, forgiveness, and gratitude.Hospice care can include long chats about today and shared memories about yesterday.Unfortunately, many patients are near death when entering hospice. Based on 2016 data, 27.9% of patients die in a week or less.
Palliative care is not just about dying, it’s about living, writes Dr Eoin Tiernan in ‘The Irish Times’. It’s about living, with a life-limiting illness, and putting quality at the centre of that time.
Research has shown the earlier a patient is referred to the palliative care service during a hospital admission, the better the clinical outcomes and quality of life.
The traditional view that palliative care implies only hospice and end-of-life care no longer holds true. Palliative care is equally important as a service to support patients earlier in the course of a serious or life-limiting illness. This can sometimes be from the time of diagnosis. Patients can receive care and support from palliative care for many years.
A referral to palliative care should not be feared. It does not always mean that a patient is imminently dying.
It is often while in hospital that patients are sickest, and will have the greatest need for the input of the palliative care service to help with complex symptoms, such as pain, nausea, breathlessness, as well as the need for emotional and psychological support.
An early referral to palliative care in emergency departments results in a reduction in the average length of stay of more than 10 days for patients compared with patients referred later during the course of their admission.