Hospice

Yesterday I had the opportunity to talk to my dad about hospice.  He has a friend who was just enrolled in a hospice program and he said that they seem to have him heavily sedated.  He said that in his experience "hospice" meant drugged into oblivion.  I was able to come at that from a different reality.  I know that Lakeview Hospice, the organization that I volunteer for,  is amazing, but I don't know about other hospice programs.  I was able to tell him that a good hospice program should cater to the wishes of the patient as much as possible.  There is a chance that his friend is no longer lucid, and that with the medication, his symptoms are exacerbated.  The patient  or loved one along with the nurse, normally decide how often to receive pain medication, and the results vary greatly. 

I related a story of a visit with a local hospice patient that I had last Friday.  "Lucille"  was just moved to hospice after she had a fall in her apartment.  We sat and talked for about 45 minutes, and she was lucid and delightful!  We held hands, played the Reverie harp, and she shared stories.  She has end stage lung cancer, and she said that she knew that she could no longer get the care that she needed at home.   During Lucille's journey with cancer, she has not had any pain but was quite uncomfortable while I was there.  She thought that she had broken at least one rib when she fell.  When she grimaced, I asked her if she was uncomfortable and when she had last had any pain medication.  She told me that she wasn't sure but knew that the nurse would come in and offer when it was time.  I reminded her that she didn't need to be uncomfortable and asked if I could speak to the nurse for her. 

The nurse came in and we talked with Lucille about how she could request different pain medication at different times.  Between all of the options, the nurse assured her that she should be comfortable.  The nurses in hospice are literally angels.  They are completely about giving care and comfort to their patients.  In my visits, I have found that if a patient's pain level changes, the nurse can contact the doctor and request an upgrade in the dosage or frequency of medication.   

Lucille was greatly relieved after our talk with the nurse and she and I decided that she would relax even more if I wrote some notes for her.  We wrote down the nurses name, and the time that she had last taken morphine.  I reminded her that she could buzz the nurse before the next dose if she was uncomfortable.  It was a delightful visit, and it felt so wonderful to show Lucille that the main interest of everyone in the facility was that she was comfortable and well cared for.  Some patients don't understand that concept after being in other homes, or in Lucille's case after taking care of herself. 


Hospice is no longer a place or process where people are drugged into oblivion until their last breath.  It can be a wonderful opportunity for patients to have some control and go their own way with dignity and compassion.