Hospice Patients Alliance: Consumer Advocacy


Receiving a diagnosis that includes a probable life expectancy of "less than six months" is one of the worst moments imaginable...for everyone involved. No special "words of comfort" or philosophical discussion is going to make it "all better." However, we can make the most of the time that is left and make the "quality of life" the best possible under the circumstances. The will to live is one of the strongest instincts within us, but all of us will die one day. Hospice offers a positive approach to coping with all the changes that accompany the dying process.

There are many factors that affect how such a diagnosis is received: the age of the patient, the "world view" of the patient and family, beliefs in God and an after-life or a belief that there is no "after-life," the nature of the disease and its cause, and many others. Although some might imagine that everyone would agree with the statement: "nobody wishes to die," it is really not possible to make such an assumption and generalize. Some who have lived a very long and full life may be ready to pass on. Those experiencing terrible pain may wish to escape it through death, not knowing that in most cases, quality hospice care can control the pain and help the patient to be more comfortable.

There is no easy answer to "why" death comes to the very young or old when it does. Each of us must find our own answers, and those answers involve beliefs about the meaning of life, purpose in living, our relationships with those around us, our work, family and friends, and our goals.

Disbelief, shock and anger at hearing such a diagnosis is common, and it may take a long time for the initial shock and anger to subside, if it ever does. Disbelief and denial are natural and understandable responses to such a life-changing diagnosis. Time, however, has a way of making the reality of the disease known. Health and energy levels may decline while symptoms worsen, all of which make continued denial impossible. Grief and depression are common.

While to some, acceptance and peace seem to be unattainable far-off goals, others arrive at a state of peace and acceptance that comforts all around and allows for the expression of loving feelings among family and friends. The imminence of death forces us to confront our own mortality, fears and beliefs. It also can help us overcome past hurts and grudges and reaffirm our love for one another. When death is imminent, we are also forced to make all sorts of decisions about the care given, interventions made, when to let go and what type of funeral arrangements will be made...all of which should be discussed with the patient to make sure his or her wishes are respected.

Hospice staff are available to listen and "be there" for the patient and family. Providing medications to control symptoms is only part of the hospice mission. Nurses, social workers and chaplains all work together to help the patient and family arrive at a peaceful resolution of the many complex issues which arise.

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