Hospice provides help at the end of life


When we enter this world we are surrounded by love, comfort and care. Don’t we deserve the same when we leave?

The controversial issue about how our society cares — and does not care — for people who are dying is being reported by Bill and Judith Moyers in a PBS documentary series, "On Our Own Terms: Moyers on Dying." It airs on Channel 9 Sunday through Wednesday nights next week.

As journalists, the Moyers felt the movement to improve end-of-life care was growing and that it was time to bring death, the last taboo, out of the closet. They saw a baby-boomer survey that reported boomers were now talking about mortality instead of retirement as their first issue. They watched as the AIDS epidemic brought death more into the open. They noted the simplistic way that the Kervorkian assisted suicide issue was handled in the mainstream media.

Both Moyers faced deaths in their own families that made them sensitive to the issues around end-of-life care.

Bill said it took his elderly mother three years to die and that he made a lot of mistakes in that period of time, including not advocating with her physician for adequate pain medication.

"I knew almost nothing about hospice, which had been growing up all around us — but I had not paid any attention," he said in an interview with Money magazine. "And the hospice workers and volunteers who came in to look after my mother taught me so much about the experience of dying. I didn’t want that experience to be lost on other people."

Although the Moyers’ series highlights some well-documented failings in care given to Americans at the end of life, it offers hope that there is increasing emphasis on providing more enlightened care to the dying.

That means having families talk among themselves about the kind of experiences they want for themselves and loved ones as the inevitable end of life draws nears.

That means taking control of your dying and not being afraid to discuss with your family and your doctors what you want to happen if you are terminally ill.

That means being sure that you have documents on hand with the appropriate people that allow you to describe the kind of care you want. A durable power of attorney for health care appoints someone to be your decision-maker if you can’t speak for yourself. An advance directive (living will) details what kind of life-sustaining treatment you want or don’t want in the event of an illness when death is imminent.

While the Moyers’ documentary looks at a number of aspects of end-of-life care, hospice care is one of the bright spots.

Nationally, the country’s 3,000 hospice programs provided care to an estimated 700,000 dying Americans last year. Unfortunately, too many of those patients entered hospice service only in their final days or even hours of life, leaving their families wishing they had known about hospice care sooner.

Hospice does such wonderful things for patients and their families during a trying time. Most of the hospice care is provided by an interdisciplinary team in patients’ own homes with loved ones participating in their care, but hospice also serves patients in nursing homes, adult care facilities and in-patient facilities.

The team approach focuses on expert medical care and pain management for the patient along with emotional, psychological and spiritual support for both the patient and family. Even grief counseling is provided for family members after a patient’s death. The holistic approach is what makes hospice care special.

The letters of thanks from families say it all. An excerpt: "Family and friends are comforted in the knowledge that your help does make a difference in the quality of life that their loved one receives under times of great stress."

Hospice is a model for quality, compassionate end-of-life care. As we move forward in taking death and dying out of the closet, let’s hope that hospice is no longer a well-kept secret.


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