Crossing Over…A Caring Hand on the Journey
By R. Joe Church, M.D., GuArdian Hospice, Texoma LIVING WELL Magazine
Dying is a normal life process, but it is difficult to imagine the fear and loneliness that consumes both the patient and family when given a terminal diagnosis. Hospice enables end-of–life control to the patient by reassuring everything will be done to lessen the physical, emotional, and interpersonal pain. It is not to hasten or postpone death. It is to enhance the quality of life for the patient and their caregivers. This is achieved with an amazing team, consisting of social workers, chaplains, aides, nurses and physicians, all working closely with the family.
The social worker assists with making health care decisions, contacting local agencies and community resources, and helps identify the emotional and spiritual needs of the patient. The chaplain makes regular visits and provides spiritual care in an open, sensitive and nonjudgmental way and aids in arranging or officiating memorial services. Nursing aides are vital in the personal care of the patient, including bathing, hygiene, and skin care. They generally spend a great deal of time developing relationships with both the patient and family. Lastly, the nurse possibly plays the most integral role, providing the eyes and ears for hospice. They possess important assessment skills and, of course, a compassionate demeanor. The hospice physician adjusts medications as needed and serves as a liaison to the referring doctor. They, along with the rest of the team, have the unique privilege of assisting in establishing goals and providing ongoing support and a caring presence throughout the patient’s life and death.
Qualifying requires a prognosis of six months or less, but is not limited to six months. Physicians should not wait until the last few days, when the patient is bedbound, to institute hospice. In fact, studies have shown an increase in median survival (in certain types of cancer) and decreased rates of depression when hospice is introduced early. The team will never ignore the patient’s request for curative treatment. If desired, he or she can choose to leave at any time to pursue such a treatment and return to hospice when ready. Starting hospice does not mean the patient is “giving up on life.” They are encouraged to enjoy life, travel and, if desired, continue the relationship with their primary care physician.
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