A simple slip of the tongue got me thinking. We were discussing how to guarantee that each patient who checks into our office has an Advanced Directive. Should the front desk ask or should it be part of the doctor’s checklist? What is the RN’s role? The nurse said, “Well, this is very important. Too often, our patients don’t make decisions until it is too late. Planning for End-of-Care Life is critical.”
She is right. It would be very important to make decisions if the doctors truly “give up on you,” and end all care. I suspect the idea that their caregiver would abandon them, is a real fear for many patients. All that would remain would be fragments of life. Then, the prospect of death becomes even more terrifying, because it also means being alone.
This is why we say, when we get it right, “End-of-Life Care.” Not only are we not going to desert you, there is a great deal of caring we can do. Pain control, ambulation, insurance and financial advise, spiritual guidance, durable medical equipment (bed, commode…), community involvement and the support a patient needs to go on … to live. Hospice and Palliative Medicine is indeed about life….about coping and hope. The timing just happens to be near its end.
We must continue to emphasize this message. Hospice does not mean we are casting you out. Palliative medicine is not what we do, when we can do nothing. Good end-of-life care is not about being dead. It is about being alive. And, as long as there is breathe in our bodies, that can be a very beautiful thing.