When Is It Time To Choose Comfort Care?
Barbara Karnes, RN
Author of GONE FROM MY SIGHT aka: "the hospice blue book", NHPCO Hospice Innovator Award, End of Life Educator
When the doctor says,?“We are having a difficult time fixing you;” “I can’t fix you,?let’s talk about comfort care;” “We have tried everything and the treatments are not working
These are the words I wish physicians had the courage to say to their patients who are facing life threatening conditions. To qualify, some physicians do address these issues with their patients in a timely manner but, honestly, many do not.?
Remember,?the medical model treats diseases that people have, not necessarily people that have disease. In today’s medical model disease is to be “fought” at all costs. Often the motivation for treatment is that what we learn from one patient’s experience,?disease?progression, success or failure, will help us learn?how to?treat others?more successfully.
Unfortunately,?this medical approach does not take into consideration?that?the body is programmed to die. Everybody dies and one of the ways it dies is because of disease.
Taking the above into consideration,?it is really up to us, the patient and family, to look for the success or decline
What can we?look for that tells us?when?it is time to consider comfort care?and?not aggressive treatment options? Comfort care being?palliative?care,?hospice?care,?and/or?End of?Life?Doula support.
1. In spite of treatment the disease?continues to progress, invade, cause pain and bodily symptoms. This appears so obvious yet in our desperation to stay alive, we often ignore the very message our body is trying to tell us.
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2. When in your heart you question if your loved one?or yourself?will be here next year. We tend to give people more time than they have. If we are questioning,?“Will I or they, really make it?” it is time to consider comfort care options.
3. Food, sleep,?and social interactions are changing. There are more naps, less social interaction,?and less and less food intake. These are signs the body is preparing to die. Yes, they are also signs of a person experiencing the reactions to treatments. There is a thin line here to be watched and observed.
4. As a patient, as a family, as caregivers, you are becoming exhausted, frightened and concerned
Bring up to your physician your concerns?and?fears about ending treatment and about the appropriateness of a palliative care or hospice referral. You do not need physician approval or a physical order for an End of Life Doula referral as you do for hospice and palliative care programs.
Approaching the end of a life, yours or someone you care about,?is time intensive, challenging, frightening,?and often heart wrenching. You don’t have to do this alone. There is support available BUT often YOU have to ask for it, the medical establishment doesn’t always offer it in a timely manner.
Something more...?about?When Is It Time To Choose Comfort Care?
If you or someone you know have been given a life limiting diagnosis, I have a booklet for how to live the best life you/they can within the confines of their body and disease. It is called?A Time To Live: Living With A Life Limiting Illness. It is part of the?End of Life Guideline Series.??
Clinical Director: Hospice, Magnolia Regional Home Health & Hospice
2 年It’s so important to give physicians and nurses and other hospice referral sources the words or scripts to use when it’s time to refer to hospice and palliative care. I am so thankful that medical schools are offering more training on these topics. These are great ways to offer this benefit. Thank you for sharing!
Senior Hospice Liason at Amedisys Home Health & Hospice
2 年This is great! So true.
Senior Living Consultant and Owner of Senior Living Partners,LLC
2 年I could not agree more