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Commentary on Hospice Care
Wednesday, October 15, 2008 • Posted October 15, 2008

Doctors are people, too. I feel certain there is a small percentage of the population who select their doctors based on credentials and past performance in their particular field of medicine. While choosing a specialist, I might be inspired to search into background and track record more, when it comes to choosing a general practitioner it’s all about a connection. We all have varying criteria, as unique as our fingerprint, when it comes to that connection, but most of us make our medical selections by feel. If we feel comfortable and feel like we can talk with this person, we go. We trust this person because we like them and we build a relationship over time. Our family practice doctor often becomes a family friend, someone we trust with our health and that of our children for years and years. This is a key relationship in the course of our lifetime because the health of our family depends on it.

I feel certain there is a percentage of the population who select doctors based on credentials and past performance in their particular field of medicine.

So, when it comes time that that trusted family friend has to tell us our disease process has reached a point of no longer being treatable and that we will soon face the end of life, how does that friend come up with the words? How can we possibly hear it from them? It sounds so final and glass-half-full. So, we avoid it, thereby coercing our family doctor to live in conflict over our care. We push the elephant over to the side and make our next check-up appointment, completely ignoring the obvious fact that it is quite likely we won’t be here to keep it. We deal with pain; we wear out our caregivers and loved ones; then, we find ourselves in the ER and our family is put in the horrible situation of having to make snap decisions regarding care that will keep us comfortable. At that time, with the elephant now sitting on our chest, hospice care is mentioned, giving us all the impression that the angel of death will ascend as that nurse enters the door. It simply does not have to happen this way.

For others, such as myself, I have always chosen my doctors based on how we connect. Typically, feeling comfortable is the key. We trust this person because we like them, and we build a relationship over time. Our doctor, particularly a family practice physician, often becomes a family friend, someone we trust with our health and that of our children for years and years. This connection is a key relationship in the course of our lifetime.I paint this bleak picture as an illustration of what I see unfortunately play out time and time again in the field of hospice care. We lay predicting our own demise at the feet of our family physician. How odd. Did we ask our doctor when we should have children? Did we consult with that friend and physician when we wanted to skydive or water ski or drive too fast on the highway? Not likely. Yet, we expect that person to have the foresight and above all superhuman powers to tell us when it will be our time to die. As my kids would say, “NOT FAIR!”

So, when it comes time for that trusted family friend to tell us our disease process has reached a point of no longer being treatable and that we will soon face the end of life, how does that friend come up with the words? How can we possibly hear it from them?

What is fair is that our death is uniquely ours and given some notice, we do have some control over how it plays out. I’ve often laughed that mine will be some crazy weird death that everyone just looks at each other blinks and says, “Wow.” So I probably won’t get the advance notice. None of us know when or how, but we all know that it will one day happen. So why can’t we take a little control over what we can control and help our physician when life gives us a little heads up. When it comes time in a disease process that treatment is no longer effective, that is the time to bring in those who specialize in making the last months or even year of life comfortable and powerful. Hospice teams across this nation are devoted to making the last phase of life the absolute best experience possible for the patient and for those who love them. It is a sacred and important time and the sooner a hospice team can assemble and support the sooner the patient and family benefit.

It is natural to try to avoid it. We push the elephant in the room over to the side and make our next check-up appointment, completely ignoring that we possibly won’t be here to keep it. We live with pain; we inadvertently wear out our caregivers and loved ones; then, we find ourselves in the ER, and our family is required to make snap decisions regarding care that will keep us comfortable. At that time, with the elephant now sitting on our chest, hospice care is mentioned.

Over and over we read in our family notes back to us that our hospice care was incredible but that it just came too late in the process. We have control to change that. Rather than waiting for our physician to tell us, why can’t we ask? “Is now a time when I or my family might benefit from hospice care?” What a gift you would give yourself and your physician if you took that kind of control. Know this . . . no one is required to die on hospice. In fact, many leave hospice care and live several more years once a particular medical crisis is resolved. It is possible. Control at the end of life is also possible.

It simply does not have to happen this way.

We lay predicting and discussing our own demise at the feet of our family physician. How odd. Did we ask our doctor when we should have children? Did we consult with that friend and physician when we wanted to go to the mountains or water ski or drive too fast on the highway? Not likely. Yet, we expect that person to have the foresight and superhuman powers to tell us when it will be our time to die.!”

Our death is uniquely ours and, given some notice, we do have some control over how it plays out. None of us knows when or how, but we all know that it will happen one day.

We need to take control over what we can control and help our physician when life gives us a little heads up. When it comes time in a disease process that treatment is no longer effective, that is the time to bring in those who specialize in making the last months or even the last year of life comfortable and powerful. Hospice teams across this nation are devoted to making the last phase of life the absolute best experience possible for the patient and for those who love them. It is a sacred and important time, and the sooner a hospice team can assemble and start providing support, the sooner the patient and family benefit.

I am Heather Fish, and I am the community liaison for Hill Country Memorial Hospice, a division of Greater Hill Country Hospice. Our hospice and that of Llano Memorial Hospice work together to bring specialized comfort care to the hill country. Both programs are affiliated with local hospitals and are staffed with health care experts who live in your community.

In future weeks I look forward to de-fanging the oftentimes taboo subject of hospice care and related. If you have questions, feel free to contact your local hospice provider.

Hill Country Memorial Hospice: 1-800-859-3169

Llano Memorial Hospice: 1-800-927-9965

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