The final stages of a terminal illness typically require a change in care for patients. Instead of treating or trying to cure a condition with remedies or medication, the focus shifts relieving the pain and symptoms of the illness and keeping the patient as comfortable as possible. This form of treatment is known as hospice care.
Individuals can obtain this type of care known as hospice when the progression of a terminal condition such as Alzheimer’s disease or cancer requires 24/7 care. Hospice care provides emotional, psychological, medical, and physical support to patients and their families.
About Hospice Care
When individuals have a life expectancy of about six months, they typically begin hospice care, although it’s very difficult to put a time frame on death. The patient’s physician determines the hospice start day, which occurs when the patient and his family understands and accepts that the terminal illness will not be aggressively treated.
It’s during this time that family and friends start formulating and saying their goodbyes. It’s not only a stressful time, but a very sad one too. The patient will only receive end-of-life care which usually includes:
- Medical services
- Social services
- Homemaker services
- Spiritual and bereavement counseling
- Occupational, physical and speech therapy
Individuals receiving hospice care are treated with dignity as they get ready to pass on. Family members, volunteers, and trained personnel work around the clock to provide the services necessary to keep the patient comfortable.
Types of Hospice Care
Patients can receive hospice in their home, at a hospital or at a special facility. The type of care depends on the needs of the patient. There are several types of hospice care available:
- Home care: According to the National Hospice and Palliative Care Organization, more than 65 percent of all hospice patients remain in their own homes when receiving this type of care. Family members and close friends play an active role in the patient’s care. A hospice team can provide regular visits or care 24 hours a day.
- Respite care: This type of care is available when a family member or friend is tending to a hospice patient at home. Respite provide a temporary relief from caregiving, allowing hospice team members to come in and provide the needed services. The patient may also move to a residential facility or hospital for short-term respite care as well.
- In-patient care: When the patient’s level of palliative care exceeds what is available at home, he enters a general inpatient care program. Hospitals, long-term care facilities, or dedicated hospice centers are typical settings for this type of care. Hospital-based hospices allow patients and their families access to immediate medical and social services. Some hospitals have a separate hospice unit while others have hospice team members on call to visit with patients. Most long-term care facilities such as nursing homes have hospice units that employ specially trained staff members to care for the patients. Dedicated hospice centers offer in-patient and in-home care services. These options are beneficial to those who do not have primary caregivers available at home.
The counselors also work with family members to imagine what life will be like without their loved one; they help them say goodbye. This can be done early on in hospice care when the individual is coherent or later on, when death is looming. It’s all up to the family and their comfort or discomfort level when it comes to this subject. When the time is right, there are many ways to say what needs to be said; however, cherish whatever time you have left together:
- Young children: The easiest way for little ones to say goodbye to a grandparent or other family member or friend in hospice care is through pictures and writing. Children can paint or color pictures of themselves with their loved ones or even write poems or short stories. To come to terms with the death itself, they can also talk about heaven or the afterlife, whichever they believe. It’s important that children are told the truth about what is happening. Use discretion when needed.
- Adult children: Although it’s imminent, children, no matter what age, never want to say goodbye to their parents. There really is no right or wrong way to do this. However, to receive some closure about what will happen, it’s best to make sure it gets done before it’s too late. Even if your parent isn’t conscious, take some time alone to be with him and speak from your heart. Since you really don’t know whether the person can hear you or not, make sure you speak clearly; talk about memories of childhood, yourself, and your family, etc.
- Spouse or partner: This one of the most heartbreaking goodbyes to say. How do you tell your husband or wife to go on with you? Frequently, spouses feel guilty for remaining alive while their partner dies. It’s best to spend as much time alone, holding hands, talking about good times and thoughts about the future. Often, especially near the end, the spouse will spend all his time visiting. That is OK, as long as it doesn’t interfere with hospice house rules.
It’s OK to Grieve
Having your loved one in hospice conjures up all kinds of emotions, including grief. Just remember, it’s OK to be sad or angry about this happening. Nobody wants to see their mother, father, grandparent, husband, or wife go through the various stages of death. It’s a terrible thing to endure. However, proper counseling and support can help surviving family members deal with the impending death and help them say goodbye properly.
Things to Remember
It is very difficult to consider hospice for a terminally ill patient. This option is considered when all types of conventional treatments no longer work. Make sure you or your loved one discusses all options with a physician before making any permanent care plans. For additional information, contact Grace for additional information on end-of-life and hospice planning.