HOSPICE

“Hospice is the quiet art of caring when curing is no longer the goal—bringing comfort, dignity, and presence to the time that remains, and reminding us that even when time cannot be extended, it can still be filled with connection, meaning, and love.”    

                      ~ Final Exodus

ABOUT HOSPICE

Hospices provide care not only for the dying person, but for the entire family. 

Hospices are a medical resource that:

  • Provide palliative (comfort) care.
  • Help patients and their families through the dying process after curative treatment is stopped.
  • Often provides services in the patient’s home, but can be provided elsewhere too.Typically hospices come to the patient's home. But hospice can assist even if the patient is still hospitalized. Some hospitals have hospice beds. Some hospices have their own beds.
  • Can choose or not to support Medial Aid in Dying (MAiD), Voluntarily Stopping Eating and Drinking (VSED), or even the inert gas method.
  • Is a Medicare benefit if the patient has a terminal diagnosis (six months or less to live).

Hospices do not:

  • Entice people to die.
  • Try to cure the patients’ illnesses, but make sure to palliate pain and discomfort.
  • Usually provide a 24/7 or even a few hours a day caretaking service. Family/friends/or paid caretakers are expected to do the majority of caretaking which is not an easy task.

THE HOSPICE PROCESS

  • The patient is interviewed by the hospice’s doctor or other medical staff. Hospices have their own medical director.
  • The doctor reviews the patient’s medical record to understand the patient’s illness and to determine if s/he is terminal–that is, has, in the doctor’s opinion, less than six months to live. Such determination is essential for hospice to be reimbursed by Medicare.
  • The doctor prescribes the palliative care.
  • The hospice nurse sees to the prescribed care and visits the patient weekly, or more often if needed. A social worker often visits too.
  • A chaplain (minister, rabbi, priest) may also visit if requested by the patient. Some hospices have volunteers who can sit with the patient, read to the paitent, do light housekeeping and sometimes haircutting.
  • Doctors visit less often or not at all.

CHOOSING A HOSPICE

In most communities there are many hospices, for profit and non-profit.  Typically hospices are staffed with doctors, nurses, social workers and clergy.  Often volunteers help with patients – such as chatting or reading to them, running errands, relieving the caregiver for a while, etc.

The first thing to do is to go to hospice websites and compare them. Then narrow your list to three or four, then ask these questions:

  • What services are provided and how often?
  • What roles do your doctors, nurses, social workers play?
  • Do you have volunteers, and if so, what can they do?
  • How do you keep patients comfortable?
  • What support is given to family and to care givers?
  • What services are provided after hours?
  • Is the hospice non-profit or for profit?
  • Do you support choices to intentionally shorten life, such as VSED, and inert gases? In MAiD states: do you support the MAiD process?
    • If so, at what level?
      • Will your doctor prescribe the lethal medication under your state's Medical Aid in Dying law? If not, will he or she be the second "consulting" physician?
      • Are your staff educated and supported to provide aid in dying care, from consideration through providing?
      • Do MD's provide care? Is there someone on staff to provide care?
      • What can your nurses and staff do or not do?
      • Does your hospice have specialized MAiD grief/spiritual care?
      • If VSED is chosen, will your staff willingly withhold food and fluid?
Often hospices are called too late in the dying process—too often the patient dies within days.  But hospice services can be paid for by Medicare for six months, and, depending on medical opinion, hospice service can last longer.

PREVENTING ALZHEIMER’S DISEASE

Extensive recent medical research clearly indicates that with a good lifestyle you can prevent developing Alzheimer’s disease. What life style changes? (As many as you can do; the more, the better.)

  1. Eat healthy
  2. Exercise regularly
  3. Avoid negative thinking
  4. Do what you enjoy
  5. Have a good sense of humor
  6. Meditate, live mindfully
  7. Socialize
  8. Get outside into nature
  9. Actively relax – listen to music, garden, etc.
  10. Get a massage – even the 15 minute ones
  11. Change your environment – take a trip
  12. Stop multitasking
  13. Turn off electronic devices
  14. Take supplements, especially B complex, C, zinc, magnesium

This list is taken from a class on prevention given at the San Diego Community Colleges in the fall of 2022. You can get similar information from this YouTube video: Ten tips to prevent Alzheimer's, Melissa Batchelor. There are others.