It’s Not About Giving Up, but About Quality of Life
From the AMERICAN ACADEMY OF HOSPICE AND PALLIATIVE MEDICINE
There may come a time when efforts to cure or slow an illness are not working and may be more harmful than helpful. If that time comes, you should know there’s a type of palliative care — called hospice — that can help ensure your final months of life are as good and fulfilling as they can be for you and your loved ones.
Hospice is not about giving up. It’s about giving you comfort, control, dignity, and quality of life.
Insurers, Medicare, and Medicaid will generally provide coverage for hospice care if your doctors determine you likely have six months (a year in some cases) or less to live if your illness follows its normal course.
So, how do you know when it’s time for hospice care? Requesting hospice care is a personal decision, but it’s important to understand that, at a certain point, doing ‘everything possible’ may no longer be helping you. Sometimes the burdens of a treatment outweigh the benefits. For instance, treatment might give you another month of life but make you feel too ill to enjoy that time. Palliative doctors can help you assess the advantages and disadvantages of specific treatments.
“Requesting hospice care is a personal decision, but it’s important to understand that, at a certain point, doing ‘everything possible’ may no longer be helping you. Sometimes the burdens of a treatment outweigh the benefits.”
Unfortunately, most people don’t receive hospice care until the final weeks or even days of life, possibly missing out on months of quality time. This may be out of fear that choosing hospice means losing out on a chance for a cure. Sometimes doctors fear their patients will feel abandoned if they suggest hospice.
Hospice care can help you continue treatments that are maintaining or improving your quality of life. If your illness improves, you can leave hospice care at any time and return if and when you choose to.
The following are some signs that you may experience better quality of life with hospice care:
• You’ve made several trips to the emergency room, and your condition has been stabilized, but your illness continues to progress.
• You’ve been admitted to the hospital several times within the last year with the same symptoms.
• You wish to remain at home, rather than spend time in the hospital.
• You are no longer receiving treatments to cure your disease.
Hospice care can free you up to ensure a time of personal growth and that you get the most you can out of your time left, allowing you to reflect on your life; heal emotional wounds and reconnect with a loved one with whom you have been estranged; visit favorite places or those with special meaning, such as a school, house, or location with a beautiful view you’ve always loved; put your financial affairs in order; create a legacy, such as a journal, artwork, or a videotaped message; or simply be with the people you love and who love you.
There are other benefits of hospice care, too:
• Hospice care allows you to remain and receive medical care in your own home, if desired and possible.
• It prevents or reduces trips to the emergency room for aggressive care that you might not want. Although you still might go to the hospital for tests or treatments, hospice allows you and your loved ones to remain in control of your care.
• Members of the hospice team can clean, cook, or do other chores, giving your loved ones a chance to run errands, go out to dinner, take a walk, or nap.
• Hospice programs offer bereavement counseling for your loved ones, often for up to a year.
Hospice care may not be appropriate if you are seeking treatments intended to cure your illness. Whether receiving hospice or palliative care, you should make a plan to live well so that your wishes for care and living are known.