Friday, March 24, 2017

Hospice

After working for years in long-term nursing, I’ve become very familiar with hospice. In fact, my first nursing job was on the hospice floor of a facility for Alzheimer’s/Dementia. Not all of our patients were on hospice, but there were quite a few that were. I loved the hospice we worked with. They were involved, and they always worked with the nurses on the floor to make sure that we all agreed on the plan of care.

Often, we had a patient who would go on hospice and would be diagnosed with ‘failure to thrive,’ especially if they suddenly lost weight, or wouldn’t eat.

Here’s the thing though, they didn’t stay on hospice until they died. Often, the doubled effort between the facility and the hospice caused the patient to have increased care and as a result of that, their health usually improved. As a floor nurse, I let the hospice nurse know whenever I had concerns, or if I thought something would be more beneficial. Increasing their protein shakes, or switching them to finger foods.

More often than not, after a few months on hospice, the patient would start to improve to the point that they no longer qualified, and hospice would discharge them into our care.

For me, hospice wasn’t an end of life kind of thing. Of course, it’s for those who have a poor prognosis, or who have been given a short time to live, but that doesn’t mean that they will die within weeks of going onto hospice. Hospice was an assist for the patient and the family so that they could cope, and, most importantly, to make sure that they were comfortable.

Unfortunately, I’ve discovered that my first experience with hospice was the exception rather than the rule. I’ve worked with multiple other hospices since then, and it often feels like the program is created to transition into death. Too often, they’re cut off everything they might need to extend their life because they’re just going to be ‘comfortable.’ All blood pressure, thyroid, or even heart medications are discontinued. They’re cut off because those medications aren’t necessary if they’re going to die. I’ve even seen hospice nurses hurry the process because they want to go home for the night.


Hospice was create for the patient and family to have support. So that they’re not alone in the experience. I’ve been there, and it can be scary, especially when you don’t know what to expect. But in the rush to help with death, I fear that too often they forget to allow life.