Monthly Archives: January 2014

Learning About Death And Dying

When a patient receives a prognosis indicating that his or her condition will lead to death, the reality of one’s own impending death can be hard to process. We know from an early age that we will die, we grieve the deaths of others, but we don’t know how we will handle the news of our own terminal illness.

At Hope Hospice, we have chaplains and a social worker who talk to patients and families about facing death. They answer questions and counsel patients and families about death and dying.

We at Hope Hospice are encouraged that many people are giving greater attention to the topic of death before it becomes an immediate concern. Those who have considered some of the many aspects of dying are better equipped to handle death when it affects family, friends or themselves.

A new book by former Los Angeles Times writer Erika Hayasaki titled The Death Class explores some of the issues involving death and dying. The book focuses on a class taught at Kean University in Union, NJ by Dr. Norma Bowe, a nurse and tenured professor.

Her course, Death in Perspective, has become one of the more popular classes on campus. Hayasaki, who had written about death and had covered tragic deaths such as those at Virginia Tech, asked Bowe if she could write about her class. Bowe invited Hayasaki to take the class. She did and the result is this book.

The complete title of the book is The Death Class: A True Story About Life. One of book’s reviews stated: “This is a beautiful book about courage—the courage to turn and face your own life and death, and the courage to make a difference in the lives of others.” Another review suggests that the essential question of book and the course is “how can we learn to celebrate live?”

When Hope Hospice chaplain John Wilson is asked if dealing with death on a daily basis is a challenge, he replies, “Yes, I deal with death, but I also deal with life.”

The book promises fresh perspectives on death and dying in America. It also may help stimulate conversations with your family and friends about death.

For The Death Class website, click HERE.

For a video featuring Dr. Norma Bowe, click HERE.

To order the book from Amazon, click HERE.

For questions about hospice care in St. Louis, call Hope Hospice at 314-984-9800.

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Hospice Survivors

One of the great misconceptions of hospice care is that it is only for those who are just days away from dying. We at Hope Hospice work to educate the St. Louis community that hospice is for all persons who have a life expectancy of 6 months or less.

But some hospice patients live beyond the 6-month time period. Upon reevaluation, a patient may be determined to be well enough to go off of hospice care. Or a patient may be recertified to allow care to continue. Hope Hospice closely follows state and federal guidelines regarding patient eligibility.

A recent article on hospice care that ran in the Washington Post points suggests reasons why some patients outlive “a legitimate prognosis of six months.” Citing an executive at the National Hospice and Palliative Care Organization and others, the article states: “A larger portion of patients today have diseases whose outcomes are harder to predict. That’s because the portion of hospice patients suffering from cancer, a disease that has a more predictable course, has shrunk.”

An article distributed by McClatchy newspapers in 2006 shares details of a Harvard Medical School study of doctors’ diagnoses of terminally ill patients: “In 4 out of 5 cases doctors’ estimates of how long a patient would live were wide of the mark by at least a third. That is, for a patient who actually died in 30 days, 80 percent of doctors predicted 20 days or less or 40 days or more.”

One reason for the increased number of hospice survivors may be the actual care provided by hospices. The McClatchy article suggests: “With the focused attention of hospice doctors, nurses, social workers and spiritual counselors, patients get their medications adjusted and take them regularly. They get painkillers adequate to assure a night’s sleep. They eat regularly, and their loved ones get some help and relief.

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A clinical director at a hospice in Pennsylvania said, “Often, just taking away the pain and enabling them to sleep through the night gives people a second wind.”

If you have questions about hospice care and the benefits of hospice care, please call Hope Hospice at 314-984-9800.

 

 

 

 

More On Learning About Hospice

When a doctor or other medical professional mentions the word hospice to a patient or a family member, where does one turn to learn about hospice?

An article posted on this site in September 2013 offers a few suggestions.

The internet provides a number of great resources. It’s possible that an online search has brought you to this page. Here are a few more online pages you may want to check out:

AmericanHospice.org

CaringInfo.org

HospicePatients.org

CaregiversLibrary.org

Cancer.org

EFuneral.com

Those sites should help you get started in your quest to learn about hospice.

Members of the clergy who visit sick parishioners and their family members may have knowledge about hospice and the various components of hospice care.

Ask your minister or priest for thoughts on hospice based on his experiences with church members and their family members on hospice.

Remember, too, that you can call us at Hope Hospice in metro St. Louis for information about hospice care. We can answer both general and specific questions. And if we don’t have the information immediately available, we’ll track it down. Our number is 314-984-9800.

When Should Doctors Talk About Hospice?

Why are many doctors hesitant to recommend hospice care? In some cases, they may be uncertain about the kind of response they will receive from the patient and the family. Doctors have told of family members reacting badly when the mere mention of hospice is presented.

In a recent article, University of Pennsylvania Health System doctor David Casarett spoke about that hesitancy, saying, “Physicians don’t want to cause that sort of distress. We’re basically nice people. We don’t want to walk in and start a conversation that will make a person start crying.”

But that hesitancy to address the possibility of hospice care can prevent patients and families from experiencing the full benefits of the care that hospice provides.

In the same article, Dr. Susan Block of the Dana-Farber Cancer Institute in Boston says, “The average time of the first conversation about end-of-life is 33 days before death. That’s really late, when you think about how much people have to come to terms with.”

She continues, “Hospice is the gold standard for end-of-life care for most people. Yet for many patients, that first conversation about hospice is the first time anyone has told them that their disease wasn’t going well.”

Dr. R. Sean Morrison of Mt. Sinai Hospital in New York offers words that doctors can share with patients when talking about hospice. He suggests doctors say something like this: “I wish we had a treatment that could take [your tumor] away, but we don’t. So we need to focus on other treatments that will enable you to have the best quality of life you can have for the longest period of time. That means focusing on pain, avoiding infections, spending more time with your family.”

We acknowledge the fact that talking about end-of-life issues can be just as difficult for doctors as it is for any of us. We encourage doctors, especially those whose patients are dealing with life-threatening conditions, to mention hospice early in the treatment process, so that patients and family members will have a better understanding of what hospice is and what hospice does.

For more information about hospice care, call us at Hope Hospice at 314-984-9800.