Considerations of Comfort Care and Hospice – by Neil Fogarty

In the 1978 movie The End, the character Sonny Lawson (Burt Reynolds) discovers he has an incurable blood disease.  Rather than undergo the agony of an extended, painful end of life, Sonny Lawson decides to take his own life.  Finally landing in a mental institution, the main character enlists the help of another inmate to help him meet his end.  This dark comedy takes end of life care to a comedic extreme, but it can teach us some valuable lessons.  When considering how to deal with an end of life decision, each individual needs to have a serious reflection and conversation about their wishes. 

The Conversation

Dr. Angelo Volandes, M.D. writes in his book The Conversation, “People simply don’t know death in its twenty-first century guise; most deaths occur in health care institutions where patients are surrounded by strangers.  By most accounts, this transformation of death from a natural process occurring at home to a medicalized event taking place outside of the home has been disastrous.”  Don’t misunderstand my point or the point of the book; there is nothing wrong with choosing to die in a hospital, nursing home, or hospice facility.  However, choice is the operative word in this discussion.  Dr. Volandes eloquently illustrates this in his book, by offering several patient stories. 

Ultimately, The Conversation is a revelation concerning what all of us should be doing as we grow older; we must talk to everyone including family members, doctors, friends, and health care specialists so they can provide us the ending we choose.  In that way, we can be just like Sonny Lawson; we can choose how the end goes.  I am grateful to Dr. Volandes for this book and I plan to use it as a conversation starter with my parents soon.  Ultimately, each person should decide how they want to be treated at the end of life.  Thankfully for us all, the hospice movement has re-opened options that current medicine forgot.

What on Earth is Palliative Care?!

So, decision time.  Do you want medical professionals to do everything in their power to keep you alive, or do you want your assembled team to make your remaining days as comfortable as possible?  This heart-wrenching decision is one to be made individually, with the guidance of family, doctors, and health care professionals.  It is a debate between quantity and quality, and local hospices are experts in helping navigate this decision.  Hospices specialize in palliative care.  Defined, palliative care provides those with a serious or chronic illness – from the time of diagnosis throughout the course of treatment – care that optimizes quality of life by anticipating, preventing, and managing suffering. In other words, palliative care focuses on the quality of the last days of your life versus extending life at all costs through medical technology and treatment.

Understand that there is no right or wrong answer here, but if you don’t ask the question you may not get to make the decision.  If your choice is palliative care (quality) over full medical care (quantity,) I strongly urge you to seek out hospice before you need them.

The Hospice Conversation

One of the largest non-profit networks of hospices in our area, is Ohio’s Hospice.  Kent Anderson, CEO of Ohio’s Hospice, understands the needs of the quality of life patient.  In his blog post, “Writing A New Chapter for End-of-Life Care,” Anderson discusses the importance of seeking out hospice professional sooner than later.  Anderson states, “the number one complaint we hear from families is a bittersweet one: ‘I wish we would’ve done this sooner.’”  His solution: “We need to be able to reach patients and their families early enough that we can bring all those resources to bear. This is so important because it’s not just one life that’s at stake. Families go through so much when caring for a critically-ill loved one. Hospice helps them take care of themselves, too.”

I agree with Kent Anderson completely, and will go even further; we need to have these conversations and make plans while we are still healthy!  Why do we wait until medical crisis to research out options?!  That would be like researching and buying a fire extinguisher while your house is on fire!  Take the time to follow the links in this blog and start planning how you want the end to happen.  After all, none of us know when the end is coming, but we can know how to tackle it when it approaches.  To learn more about hospice care, click here.

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