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Thinking about Hospice Care

Posted Jul 15 2009 8:06pm
There are many common misconceptions to address when one starts a conversation about hospice care. Unfortunately, we seldom envision the family holding hands around their declining loved one with lilting harp music in the background.

But such an idyllic setting could be much more common, says one representative from Hospice by the Bay, a Bay Area-based non-profit organization providing end-of-life hospice care and family counseling.

“It’s not so much about death as it is about a person’s life,” says Kathleen McQuoid, RN, who works for Hospice by the Bay as a nurse and educator.

McQuoid addressed the July meeting of San Francisco Senior Roundtable on July 9, 2009, at AgeSong. The talk she gave on “Approaching End of Life: Death, Dying and Advanced Directives,” raised thought provoking questions and illuminated for the group what the process of selecting hospice care really means for individuals, families and healthcare providers.

Hospice care comes into play following a doctor’s prognosis determining that an individual has less than six months to live. Common diagnoses involved in determining hospice care include Chronic Obstructive Pulmonary Disease (COPD), Renal Failure, Congestive Heart Failure (CHF), Liver Disease, Ischemic Heart Disease, Refractory Severe Autoimmune Disease – such as Lupus or Rheumatoid Arthritis – Diabetes Mellitus, Acquired Immune Deficiency Syndrome (AIDS), Neoplasia, Neurological Disease, Cerebrovascular Accident (CVA or stroke), Amyotrophic Lateral Sclerosis (ALS), Parkinson’s Disease and or Dementia, according to the organization.

Studies have shown that selecting hospice care increased lifespan on an average of 29 days for patients and many families have stated that they wished they could have started hospice care earlier in their selection process.

“Clients have said to me that before I’d knocked on their door, they’d expected the Grim Reaper or something,” McQuoid said. “Hospice is really about life, how we lived it and how we want to move on to something different,” she said.

She added that death doesn’t always happen “like this,” snapping her fingers.

Generally hospice care includes determining the less than six month prognosis and the decision for patient and family to surrender aggressive forms of treatment. Medicare typically covers up to six months of hospice care financial support. Hospice care focuses on palliative care, treating symptoms rather than the disease itself and pursuing maximum comfort for the patient.

Hospice by the Bay is the second oldest hospice support service in the nation, serving the Marin, San Francisco and Sonoma areas. Their services also include durable medical equipment, pain management assessment and pursuit of non-pharmacological methods of treatment.

“Death can be very much like birth; they don't always happen right away and both take some planning,” McQuoid said. She recalls one patient jokingly referring to the process by saying, “Well, the bus hasn’t arrived yet.”

“We want to make this more of a celebration of life,” McQuoid said.

For more information about the hospice care selection process or Hospice by the Bay, please visit: www.hospicebythebay.org.
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