Ashley, Author at Katy Hospices

The Idea of a Good Death

No one likes to think or talk about death and dying. But it’s a reality we all face-more and more people are taking charge of how they will live out their final days. This becoming known as the “good death.”

Through life, we want to have as many new experiences as possible but in the end what really matters are the simple things. This is found in many cultures and known as socioemotional selectivity theory. We simply want companionship. Most importantly, the patient must be content with the decision. Which means, as hard as it may be, ask them what would make them comfortable-giving a sense of control. A “good death” can be achieved just by talking about it.

In recent research, patients and families claim there are three important factors to consider.

Being pain free
Being in a good head space
Patient is in an environment comfortable for them
Hospice’s main goal is helping with all of these factors. With legislation changing constantly, hospice care is becoming easier to choose. Nearly all insurance (private and public) covers hospice care. 80% of patients are cared for at home, making them feel as comfortable as possible. In return, making for a “good death.”

All in all, comfort and being content are the top priorities. Hospice care professionals take pride in honoring the wishes of the patient.

So take the time to think about how you would prepare for your “good death.” What would make you most content at the end?

The History of Hospice

The term hospice is derived for the word “hospitality.” Dating back to medieval times, it was know as a place where ill travelers could stay during their journey. It was until 1948 was the term “hospice” used in medicine. Dame Cicely Saunders created the first modern hospice in London, St. Christopher’s Hospice.

Here is a timeline of the history of hospice.

1965: Florence Wald, then Dean of the Yale School of Nursing, invites Saunders to become a visiting faculty member of the school for the spring term.

1967: Dame Cicely Saunders creates St. Christopher’s Hospice in the United Kingdom.

1968: Wald takes a sabbatical from Yale to work at St. Christopher’s and learn all she can about hospice.

1969: A book based on more than 500 interviews with dying patients is published, entitled, On Death and Dying. Written by Dr. Elisabeth Kubler-Ross, it identifies the five stages through which many terminally ill patients progress. The book becomes an internationally known best seller. Within it, Kubler-Ross makes a plea for home care as opposed to treatment in an institutional setting and argues that patients should have a choice and the ability to participate in the decisions that affect their destiny.

1972: Kubler-Ross testifies at the first national hearings on death with dignity, conducted by the U.S. Senate Special Committee on Aging.

1974: Florence Wald, along with two pediatricians and a chaplain, founded Connecticut Hospice in Branford, Connecticut. The first hospice legislation is introduced by Senators Frank Church and Frank E. Moss to provide federal funds for hospice programs.

1979: The Health Care Financing Administration (HCFA) initiates demonstration programs at 26 hospices across the country to assess the cost effectiveness of hospice care and to help determine what a hospice is and what it should provide

1982: Congress includes a provision to create a Medicare hospice benefit in the Tax Equity and Fiscal Responsibility Act of 1982

1993: Hospice is included as a nationally guaranteed benefit under President Clinton’s health care reform proposal. Hospice is now an accepted part of the health care continuum.

2005: The American Heart Association and the American College of Cardiology release new guidelines about treating heart failure that includes recommendations that hospice care education be provided early in the course of an illness.

2014: Forty years after the creation of Connecticut Hospice, NHPCO and its affiliates celebrate 40 years of hospice care in the US.

Hospice and Cultural Consideration

Houston is known for being the top city for cultural diversity, passing New York City and Los Angeles. Understanding how different cultures approach death is very important. Through hospice, we provide grief services for everyone involved, but cultural practices are often overlooked. There are many transitions that happen at the end of life and through these transitions there things you should consider.

a patient’s perceptions of health and suffering;
a patient’s perceptions of death and dying;
accepted health care practices and remedies;
accepted religious and spiritual beliefs, practices, and rituals;
communication patterns and common forms of expression;
the role of family, relationships

Once these things have been observed, the hospice provider can give the patient the proper care. The patient may believe that pain and death are a part of the journey of life. They may also believe that their family must be involved in all areas of their care. Some have religious limitations or rituals important to their end of life process.

Some may want nondisclosure about the serious illness of their loved ones. The reasoning behind this is discussing death is impolite in some cultures, or they don’t want unnecessary anxiety felt by their loved one. However, in 1990 the Federal Patient Determination Act and Patient Self Determination Act were passed, emphasizing the need for the patient’s consent.

The way to handle these situations is to be respectful of different cultural practices. By having respect and appreciation it will be easier to form a relationship with the patient and their family. Expanding your knowledge of different practices is important as well. The goal of hospice is to bring comfort to the patient and understanding their beliefs is a big part of that.

7 Hospice Myths and Misconceptions

Hospice care isn’t always the easiest thing to talk about and many people don’t have a clear idea what hospice actually is. Even after 25 years, most Americans aren’t aware of the advantages hospice brings. This mostly comes from our country’s resistance to talk about death. However, hospice is undoubtedly this best choice for end of life care. Not only for the patient, but the family as well. It’s so important to talk about and dismiss the myths that surround the hospice community.

The definition of hospice is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and spiritual needs. Here are seven of the most common myths of hospice

Hospice is a place– Actually, hospice care takes place wherever the patient needs. 70% of hospice patients are cared for in their homes.

Hospice is only for Cancer patients or AIDS patients– Statistically, more than half of hospice recipients are diagnosed with other terminal conditions. Serving families coping with the end-stages of chronic diseases, like emphysema, Alzheimer’s, cardiovascular, and neuromuscular diseases.

Choosing hospice means you have given up– The beautiful thing about hospice is that it helps families share in the end of life process, through personal and spiritual connection. Many families find immense comfort when looking back, knowing they did everything possible to make their loved ones final hours peaceful and comfortable.

Hospice is just for the patient– Hospice is a family-centered program, focusing on the grieving families just as much as the patient. Many hospice providers reach out the community as well.

Hospice is only for the elderly– Hospice care is for all ages. However, most patients are seniors.

Medicare won’t cover services– Beneficiaries can use their Medicare hospice benefits anytime they choose.

Hospice isn’t for people who need a high level of care– Most hospices are Medicare-certified, requiring that they employ experienced medical and nursing personnel with skills in symptom control.