Hospice or Palliative Care: Management
Many people consider hospice to be a place where people go to die. However, hospice (or palliative care) is not a place, but a special type of care for terminally ill patients and their families. Terminally ill means that the patient's illness cannot be cured and he or she is going to die from the illness. Therefore, hospice care is not meant to cure the patient, but only to provide comfort for him or her. Hospice caregivers often provide this type of care in the patient's home, but can also provide it in a hospital or nursing home.
The goal of hospice care is to help terminally ill patients and their families cope with the end of life. Hospice is made up of a team of caregivers who specialize in end-of-life care. This team usually includes doctors, nurses, social workers, counselors, home health aides, or trained volunteers. Usually a family member or close friend is the main caregiver, who helps the patient make important decisions.
The hospice team tries to make the patient's death as peaceful and painless as possible. The team may use medical treatments to help ease the patient's pain and discomfort. However, it is important that the patient and family members understand that any treatment the team provides will not prolong the patient's life.
Palliative care approaches
The goal of palliative care is to provide treatment that eases the patient’s pain and other symptoms, as opposed to trying to cure the disease causing the symptoms. Palliative care specifically addresses quality of life issues and symptom management.
Communication plays a very large role in palliative care. Good communication between the patient, family, caregivers, and hospice team or health care providers can provide comfort, relieve stress, and ease the fears of everyone involved.
Addressing the patient's quality of life is the central focus of palliative care. This may mean addressing psychological, spiritual, and social issues, as well as the physical symptoms the patient may have. It is very important that the patient feel as comfortable as possible.
Dying at home
Many people choose to receive hospice care in the comfort of their home, which means that they choose to die in their home. There are advantages and disadvantages of a home death, which people need to consider when making their decision.
When diagnosed with a terminal illness, many people feel a loss of control. A home death allows them to keep some sense of control over their lives. It also provides a more comfortable setting in which to die. However, while dying at home may be the right choice for some patients, family members and caregivers have to decide if they can provide the intense care needed. They must also decide if they can cope with the care and how having their loved one die at home will affect them.
When a patient chooses to die at home, it is important for his or her family members and caregivers to learn what to expect. The hospice team will provide them with information and support. This will help them cope with the issues and emotions involved in a home death. Family members and caregivers need to be prepared for the symptoms and suffering that may occur while the patient is dying. They also need to know how to manage the symptoms and whom they should contact if the symptoms cannot be controlled, in an emergency, or when death occurs. With the right support and education, some families find that a home death can be a rewarding experience.
Grief and bereavement
When a person is very close to dying, his or her family members may begin to feel grief. Grieving is a natural response to loss. Bereavement (the state of sorrow over the loss of a loved one) support is a very important part of hospice care, and it should begin before the death occurs.
The hospice team helps the family grieve by guiding the family as they say good-bye. Expressing love and other emotions is very important when someone is near death. It can be helpful for family members to share stories and look through photos with the patient. Sharing memories is a great way to ease grief and recall the happy moments in the patient's life.
Family members should also try to settle any conflicts that may exist before the patient dies. Family members should try to resolve any issues that they fought over. This helps to relieve any guilt or regret they may feel after the patient is gone.
Grief is a process that takes time; the amount of time depends on the individual. The hospice team will generally tend to the survivor(s) for up to one year, recommending support like counseling, support groups, and educational classes. Without the proper bereavement support, the survivor(s) are in danger of developing a more severe grief response. The hospice team needs to check for signs of this behavior (such as suicide attempts or drug abuse) and help guide the survivor(s) in a safer direction.