Monthly Archives: October 2014

Being Mortal


Dr. Atul Gawande has written several books and articles about modern medicine. His new book Being Mortal encourages the medical community—and the rest of us—to examine the way we face the end of our lives.

He writes of his own medical training: “I learned about a lot of things in medical school, but mortality wasn’t one of them. Our textbooks had almost nothing on aging or frailty or dying. How the process unfolds, how people experience the end of their lives, and how it affects those around them seemed beside the point.

The way we saw it, and the way our professors saw it, the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.”

He writes about a revelation he had early in his medical career: “Within a few years… I encountered patients forced to confront the realities of decline and mortality, and it did not take long to realize how unready I was to help them.”

A story about a cancer patient who chose a difficult surgery over comfort care ends with Dr. Gawande writing: “What strikes me most is not how bad his decision was but how much we all avoided talking honestly about the choice before him… The chances that he could return to anything like the life he had even a few weeks earlier were zero. But admitting this and helping him cope with it seemed beyond us. We offered no acknowledgment or comfort or guidance.

Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.”

He writes about his daughter’s piano teacher Peg and her terminal illness: “I suggested that Peg try hospice. It’d at least let her get home, I said, and might help her more than she knew.

The hospice team put a hospital bed on the first floor so she wouldn’t have to navigate the stairs, organized a plan for bathing and dressing, adjusted her pain medications until they were right. Her anxieties plummeted as the challenges came under control.”

Dr. Gawande offered this comment regarding end-of-life: “People want to share memories, pass on wisdoms and keepsakes, connect with loved ones, and to make some last contributions to the world. These moments are among life’s most important, for both the dying and those left behind. And the way we in medicine deny people these moments, out of obtuseness and neglect, should be cause for our unending shame.”

One online reviewer said: “This book should be required reading for all physicians.”

Another wrote: “I’ve asked my wife to read the book so that we can discuss the final chapter in our own lives and make better plans on how to preserve the things we value for as long as we can. Making these decisions will force us to answer such questions as when is it time to say “enough is enough” to medical care.”

Being Mortal by Dr. Atul Gawande brings important end of life issues and questions to the table. The fact that they are written by a leading Boston surgeon who also teaches at the Harvard School of Medicine means that these thoughts will reach the eyes and ears of many members of the U.S. and world medical community.

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


Hospice: The First Steps

Where does a family member begin when the need for hospice care for a loved one becomes more than just a vague, distant possibility?

Begin with research. Go to your computer. Numerous online resources offer information about hospice care.

Talk to friends, neighbors, co-workers and fellow church members. Those who have had family members in hospice may be able to share useful input. Realize that one family’s experiences may vary widely from those of another.

Talk to medical personnel. Your loved one’s doctor, your physicians and others you know in the medical community.

Call us at Hope Hospice. If we cannot answer your specific questions immediately, we’ll get back in touch with the information you need. Our number is 314-984-9800.

Here are some of the basic facts of hospice care in the U.S.:

  • Most hospice care happens at home or in a nursing home or assisted living facility.
  • A person is deemed eligible for hospice care when a doctor determines that he or she has a life expectancy of 6 months or less.
  • The cost of hospice care is fully covered by Medicare. Also, many state Medicaid plans and private health insurance plans cover hospice care.
  • A primary goal of hospice care is pain and symptom control. Hospice works to help a patient maintain a good quality of life for his or her remaining time.
  • Hospice care is a team effort involving doctors, nurses, home health aides, social workers, chaplains and other support personnel. (Hope Hospice has a massage therapist to help with patient comfort.)
  • Hospice does not provide 24/7 nursing or personal care. It is up to family members or other loved ones (or hired caregivers) to serve as primary caregivers.
  • Hospice team members can provide guidance to caregivers who may be unfamiliar with all the necessary elements of home care.
  • A hospice agency may provide equipment such as hospital type beds and adult diapers.

The more you learn about hospice care before you or the doctor makes the call to the hospice agency, the better it is for you, the caregiver and for the patient.

You can call Hope Hospice (based in St. Louis county) with questions at 314-984-9800. You may also visit our website:













Hospice and Nursing Homes

Hospice patients receive care in private homes and in nursing homes. A family member or other loved one may not, for any of numerous reasons, be able to take care of a hospice patient at home. A nursing home may be the best option.

For those in nursing homes, hospice professionals provide most of the same services they provide for patients in private homes.

Hospice teams help patients in nursing homes, as well as their families and nursing home staff. When care is properly coordinated between hospice staff and nursing home staff, the patient benefits and family members are reassured.

Frequent visits by hospice nurses allow the hospice to keep close tabs on a patient’s condition. A hospice physician may visit the patient as needed.

An important part of the hospice care for nursing home patients is pain control. The hospice team makes sure that the patient has medications to address pain and discomfort. The hospice staff works closely with nursing home staff to make sure medications are administered correctly.

Good communication is vital. When a hospice care team gives information about a patient’s specific condition to the nursing home team members, it helps the nursing home staff provide the best possible routine daily care. Likewise, the nursing home team—who work with the patient on a continual basis—needs to be ready to share important information about the patient with hospice personnel, especially significant changes in a patient’s condition.

Of course, the hospice team provides the same emotional and spiritual support to nursing home patients and their families that they offer to those receiving hospice care in private homes.

If a determination is made that your loved one should transition into hospice care and circumstances make it difficult for you to be a caregiver, call us at Hope Hospice and let us help you place your loved one in an area nursing home that meets your needs. Call Hope Hospice at 314-984-9800.




Walk To End Alzheimer’s (St. Charles, Missouri)

LArge group

A large crowd was on hand Saturday, September 27, at St. Charles Community College in Cottleville for the St. Charles Walk to End Alzheimer’s.

Hope Hospice brought our Memory Wall to allow walk participants to write a sentiment or share a thought about a family member or friend who has been affected by Alzheimer’s.

Wall before

Girl writingFolks signing the wall

Many of the walk participants took a moment to sign the wall and most of the words they wrote touched our hearts.

Ophelia 2

Wall post 2

Several members of the Hope Hospice staff along with Hope Hospice volunteers greeted walk participants and made sure there were plenty of Sharpies for signing the wall.

Sarah frameHope crew lou-farhidJill and kid

The Walk To End Alzheimer’s and all the work done by the Alzheimer’s Association calls attention to a condition that affects millions of Americans who have the disease as well as many more who serve as their caregivers.

If you were not able to participate in the Walks in St. Charles or St. Louis, you can support the work of the Alzheimer’s Association by going to for information and donation opportunities.

For information about hospice care in metro St. Louis, call Hope Hospice at 314-984-9800. We can talk to you about hospice care for Alzheimer’s patients, as well as other conditions.

Special thanks to Curt Bilbrey who constructed the Memory Wall and set it up!

back of wall