Hospice can be an invaluable resource for people with end-stage COPD and their overworked, overwhelmed caregivers. But before I get into that, let me apologize... I'm writing 3 posts today, and they're all a bit on the depressing side, because they deal with death.
I don't mean to remove all hope for people fairly new to COPD as they read these posts. There are many opportunities for hope and a certain quality of life, even after a diagnosis of COPD. But it's also a fact that COPD is a chronic, progressive illness for which there is no cure. Eventually, death does become a reality. It can take years, but it will happen at some point. So, while it's important to live life to the fullest as long as you can, it's also important for both patient and caregiver to prepare for what is coming in the future.
So, this post is about how hospice can help, and the sooner it is initiated once the end is approaching, the better. Unfortunately, many people do not get referred to hospice (or are not ready to accept it) until far too late. And at that point, there may not be time for hospice staff to do what they are so good at... easing the way to a dignified, peaceful death.
My mom was referred to hospice during a recent hospitalization... and it turned out to be far too late. Although I have said that she was "dying for the last 2 years" more than once, in the end, she deteriorated so rapidly that we weren't even thinking hospice before she went into the hospital. And then it was too late for her (or us) to reap the benefits, for the most part.
What Is Hospice?
Hospice is a concept of care that provides comfort and support (on several levels) to patients and caregivers when traditional medical care can no longer prevent death from coming on, usually within a few weeks or a few months.
Hospice is a team-oriented approach that neither prolongs life nor hastens death. According to the Hospice Foundation of America, "the goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity."
Hospice care is not just about providing physical care, though that is certainly included. It's also about the emotional, social, and spiritual impact of the disease and of the dying process.
Hospice does not usually refer to a place. 80 percent of hospice care is provided in the patient's home. The emphasis is on enhancing comfort and reducing any pain or distress.
Who Needs Hospice?
When the doctor says that nothing more can be done to improve or even maintain respiratory function, and that death is likely within the next one to six months, then hospice should certainly be considered. Hospice doesn't mean giving up... it means making a conscious choice to focus on the quality of your life in your last days and then to go out on your own terms!
When you accept hospice, though, you are accepting that you will no longer be accepting life-sustaining or invasive treatments, except in the case of an emergency. It also entails acknowledging "Do Not Resuscitate" (DNR) status. In other words, if your heart or lungs stop working, you do NOT want emergency personnel to initiate treatment that would get things going again.