Sadly, everyone has to face an end of life scenario at some point(s) in time.  It may be a parent, a sibling, a friend, a spouse, or it may be your own life that needs to be prepared for an exit strategy.  My mother has developed a gradual trend of weight loss for each month of this year.  Her eating difficulties, primarily swallowing food or medicine, is probably to blame.  Mom's doctor is contacting Hospice at my request to schedule an evaluation of her overall condition to see if these services are right for her at this time.  The "Failure to thrive" diagnosis is based on weight loss, the extent of her dementia and her borderline kidney function.  There is also an undetermined mass in her upper right lung.  Mom's mobility is near wheelchair bound.  She is terminally ill.

I want to talk a little about Hospice because it appears to me that there are many people who don't understand what it does and what it doesn't do.  My mother is one of those people.  She never understood it and thought that it was a form of closet case suicide.  In her mind, doctors and nurses conspired with a patient or family member to provide an overdose of morphine that would expedite the onset of death.  I can understand how she may have arrived at that false assumption when her brother was dying of Alzheimer's Disease.  She overheard a nurse ask her niece if she should give her dad something to "help him die".  My mom's brother was having a particularly difficult time choking and gasping for air.  He was in a lot of distress and could have been spared a lot of suffering by being placed into a sleep state until death could occur naturally.  My mom failed to grasp that the "help" was sleep, not an overdose of drugs.

Hospice strives to provide comfort during the end of life experience.  They look to utilize bed padding, gel cushions for seating, etc., to prevent painful pressure sores or other types of pain.  In addition to these physical comforts, they also arrange for spiritual comforts and help the family prepare for the loss of a loved one.  Medication is also a tool that can get someone who is in too much distress, some welcome relief through sleep.  Near the actual end, life can linger for two or three days of absolute terror and mental anguish.  As the body loses function, the brain comprehends the approach of the end.  It's quite scary and very stressful.  The body will often lapse into and out of consciousness during this period.  Medication can lessen those periods of consciousness if the terror is excruciating.

Hospice can also arrange for added help to give caregivers a break.  Being with someone for hours and hours as they are dying is very stressful.  Breaks for meals and sleep are essential.  The desire to stay close and be with the loved one until the end, is understandable, but often not practical.  Being with someone for 24 hours per day over a three or four day period is tough.  Having someone else "cover" during time away is reassuring.  Hospice will provide some good advice when clear thinking may be affected by stress and lack of sleep.  They are there to help.  If you don't take care of yourself in this situation, you may experience health problems or have a car accident for lack of attentiveness.