Deciding where you will
receive care as your illness progresses can be challenging, but planning now
for your care can decrease your anxiety later on. Talk to your loved ones about
the type of care you would like to receive at the end of your life. Discuss
their expectations as well as your wishes, care needs, finances, and the needs
of your family. Your choice may change as your illness changes.
study of seriously ill patients in hospitals and their family members showed
that the most important elements of end-of-life care were:1
- Trust and confidence in the doctor who is treating the
- Having the option of not being on life
- Effective communication between the patient, the patient's
family, and the doctor.
Several care options are available, including hospice,
home care, nursing home placement, or care from an assisted-living facility. Your choices may be limited by your medical coverage or what you can afford to pay.
Studies show that most people die in a hospital or nursing home.2 If you would prefer to have your final care at home, planning ahead may allow you to do so.
As death nears, you may choose to
receive help and support from
hospice. Hospice care focuses on using
palliative therapies exclusively to manage pain and
other symptoms when there is no cure for your condition and death is
anticipated within the next 6 months. Part of this care is keeping you as
alert and comfortable as possible in a familiar environment, surrounded by your
family and friends. When you choose hospice care, you agree to forego curative
and life-sustaining treatments. But you can change your treatment plan at any
Hospice care is provided by a team of health workers,
including nurses, social workers, volunteers, counselors, and personal care
assistants. Your doctor can continue to direct your care and work closely with
you and the hospice team. Hospice care most often occurs at your home, although
it can be given in a nursing home, a hospital, or a hospice center. If you
remain at home, the hospice team supports your family in their caregiving. And
"family" is not limited to your spouse (or partner) or blood relatives. Friends
from your workplace, church, community, or neighborhood may be considered part
of your family.
Hospice care seeks to relieve physical symptoms
and address your emotional, social, and spiritual needs, as well as the needs
of your loved ones. Hospice offers a chance to address difficult but normal
concerns that you and those you love may have about death and dying, such as
pain, unresolved issues, and caregiving needs. If you choose, the counseling
and support services that hospice provides will offer opportunities to work on
mending important relationships and to explore spiritual issues.
The hospice team can help with
advance directive forms and with legal and financial
affairs. Also, hospice staff can answer questions about treatment and what to
expect during the dying process. The team can also help with
physical needs, such as bathing and pain control.
are a benefit of many private health insurance policies. Check your health plan
for specific information about hospice coverage. Also, if you qualify for
Medicare benefits, hospice services are covered through the
Medicare hospice benefit.
information on choosing hospice, see the topic