Hospice Care: Comfort and Care at the End of Life
Hospice Care: Comfort and Care at the End of Life
Hospice care is often misunderstood as simply a place to stay, but it is actually an approach to patient care aimed at providing comfort and dignity in the last stages of life. Hospices are specifically designed to give patients who are facing a limited life expectancy a place to receive palliative care, ensuring they are as comfortable as possible. This article will explore the concept of hospice care, its approach, and the experiences of loved ones navigating this challenging time.
Understanding Hospice Care
Hospice is a practice of providing care for patients with a limited life expectancy, typically six months or less. The focus is on managing pain and other symptoms, supporting the patient's quality of life, and providing emotional and spiritual support to both the patient and their loved ones. Hospice care is not limited to a specific location; it can be provided in the patient's home, a hospital, or a hospice-owned facility.
My husband spent his last six weeks of life receiving hospice care. He initially stayed at home, but towards the end, he was transferred to a hospital-based hospice facility for better support. This experience taught me the importance of hospice in providing comfort and care during the end-of-life journey.
Personal Experiences with Hospice Care
My dear friend, after her diagnosis, enrolled in hospice care and chose a hospice house, a home-like facility with calming decor and a welcoming visitor lobby. Hospices do not just provide a place to stay; they offer a place where patients can receive the best possible care at the end of their life.
In my husband's case, he was in hospice care for the last six weeks. I visited his oncologist to discuss the possibility of hospice care, and the family was matched with a caseworker/nurse who could address any concerns and questions related to symptoms and medications. Hospices are dedicated to ensuring patients are as comfortable as possible, with the primary goal of providing quality of life rather than focusing on a cure.
My Background as a Nurse in Hospice Care
As a nurse who has worked in hospice care, I have seen firsthand the care and support provided by hospices. Hospices do not just provide medication; they are focused on the patient's overall comfort. This includes managing pain, treating symptoms, and ensuring the patient is kept clean and comfortable.
One of the key aspects of hospice care is the administration of pain medication. We provide as much pain medication as necessary to keep the patient comfortable, with doses that are adjusted based on the patient's needs. Patients can have extra pain medication up to every hour if necessary. We operate on the "rule of three," ensuring the patient is not in pain and that doses are managed effectively.
Hospices are also concerned with providing comfort through hospice-infused hydration and nutrition. If a patient is unable to eat, they are not forced to do so. Food is treated as a comfort measure, and hydration can be provided through hypodermoclysis (clysis), a method that runs through the skin rather than a vein. This approach ensures that patients are as comfortable as possible, regardless of their physical state.
Addressing Neurotoxicity and Other Challenges
Patients on pain medications may develop neurotoxicity, characterized by hallucinations and increased sensitivity to touch. Hospices address this through the administration of sedatives and fluids, a process known as opioid rotation. There is no ceiling dose on any pain medication, so we can provide as much as necessary to control pain.
When severe pain and other distressing symptoms cannot be relieved with medication, hospices may consider palliative sedation. This involves giving a continuous clysis of a sedative to allow the patient to sleep. This can be done for a short period or until the patient passes from sleep into natural death. It is important to note that the medication itself does not cause death; the patient will still receive all the care they would have if they were not receiving palliative sedation.
Conclusion
Hospice care is a vital service that provides comfort and support during the end-of-life journey. It is not just a place to stay, but a philosophy of care that focuses on the patient's quality of life. As a nurse who has worked in hospice care, I have witnessed the incredible work done by hospices to ensure patients and their loved ones have the best possible experience. If you or a loved one are facing a terminal illness, hospice care can provide the comfort and support needed to live the remaining days with dignity and peace.