Two hundred and sixty two sunrises and sunsets transpire before the sun comes up on the second of July, the very day of the year that is the exact halfway mark for the calendar year. Of course we have already passed that mark and also the whole month of June, the month that marks the halfway point to the holiday season. I guess it’s fair to say we are clearly in the so-called dog days of summer and so that means fall is just around the corner!
When autumn comes our way, many of us begin to think about the holidays – gift giving, get-togethers, and travel. Others, though, may be preoccupied with a serious illness or even end-of-life concerns. If you or a loved one has received a terminal diagnosis, considerations for the upcoming holiday season likely will be different this year.
Prognosis and Goals of Care
Two essential things to think about and discuss with the physician and loved ones after a terminal diagnosis are a prognosis and goals of care. A prognosis is a forecast of the likely progression of an illness. As patients and consumers, we need and are entitled to hear the whole story, based on past experiences of the health care provider. “Where is this headed and what can I expect?”
Goals of care can include quality of life, avoidance of premature death, relief of suffering, how much medical intervention a patient is willing to undergo to gain more time, and support from family and loved ones. Being surrounded by loved ones in the home during the holiday season can certainly count as a meaningful goal of care. For various reasons this might not be for everyone, but for the sake of this discussion, let’s just say it works for you and/or your loved one.
It’s Always Too Early until its Too Late
It is a fact that seventy per cent of people say they want to die at home, yet seventy per cent of us die in an institution. When a physician tells a patient that given the natural course of their illness, their life will likely end in six months, hospice care is warranted. If one of a patient’s dying wishes is to remain at home, hospice care can meet that need.
Three lesser known facts are:
1.) Hospice care is covered by Medicare https://www.medicare.gov/what-medicare-covers/part-a/how-hospice-works.html ;
2.) If a patient lives past the six month timeframe, they only need to be recertified by the physician and uninterrupted coverage continues;
3.) The national average length of care under hospice service is around two weeks. What this last fact tells us is that when individuals and families hesitate to inquire or procrastinate to act out of fears (known and unknown), the positive and profound benefits of hospice service are diminished.
Hospice care does not prolong life or speed up death. Rather, it is focused on improving the quality of life at the end of life. Simply stated, an earlier referral to hospice service means patients are able to receive comfort care at home. Earlier referrals to hospice services allow individuals, friends and family to use energy and spend time on legacy-centered activities including establishing, rebuilding, and even strengthening relationships through visits and storytelling. Attention and care can be given to completing important tasks, including putting financial and legal affairs in order, attending to spiritual needs, and affording that everlasting gift of a meaningful goodbye.
Be Thoughtful, Be Kind, Be Brave
There is no better time than now to learn more about hospice care because knowledge is power; you have everything to gain and nothing to lose. To obtain more information about palliative and hospice care visit https://www.nhpco.org/. To locate a hospice, visit https://www.nhpco.org/find-hospice. At its core, the holidays bring about opportunities for caring and sharing. If you or a loved one has been given a terminal diagnosis, be the brave person that opens this important conversation. For someone, it may result in the greatest gift of a lifetime.