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Hospice and Palliative Care

 

 

By Cathy Huizar-Rea
For Today’s Catholic

“I’m sorry; we have exhausted all treatment options. Have you considered hospice for your loved one?” As Catholics, this statement or question should not make us feel uneasy or hopeless. We are taught that although our earthly body dies, we are restored to wholeness by our Savior. Easier said than done for some of us.

As community liaison for people who qualify for hospice, I am able to meet with patients, their families, and the medical community to share information about this underutilized resource.

November is National Hospice Month. Often times, we find that patients, families or even doctors still have the perception that hospice means the patient’s death is eminent. The goal of hospice is to focus on not only the patient and their needs, but also the needs of their loved ones. Physical, emotional and spiritual needs are addressed while affirming life and helping the involved parties make the most of their time left together.

Hospice is for any individual facing a life limiting illness, when doctors believe under the normal progression the prognosis is six months or less. What many people do not realize is that with the assistance of hospice, patients are living longer due to the elimination of treatment that is no longer effective. Hospice does not mean patients will have all of their medical care stopped. What it does focus on is comfort. Hospices continue to treat for UTIs, upper respiratory infections or general illnesses. Hospice does stop curative treatment for the medical diagnosis for which the patient is certified hospice appropriate. Patients may keep their own doctor throughout hospice treatment if they chose too. The hospice team (physician, nurse, nurse assistants, social worker and chaplain) work to create a supportive environment. Supplies and other resources are also covered under the hospice benefits.

When possible, hospice should be presented early in the diagnosis of the life limiting illness. If you or a loved one answer yes to several of the following questions, it might be time to discuss with your doctor the possibility of hospice care with your doctor:

• Have I been to the hospital multiple times in the last six months?
• Have I started using or requesting medication to lessen my physical pain?
• Have I fallen numerous times or experienced weight loss making my clothes hang or bag on me?
• Do I need more assistance with daily activities like bathing, eating and dressing?

Hospice provides an opportunity for a better quality of life when curative treatment is no longer effective. Hospice treats the whole person, not just the disease. Medicare and Medicaid both pay 100 percent of hospice services, and many private insurance companies also have a hospice benefit.
It is important to realize you have a choice when it comes to who provides your end-of-life care. I would encourage you to seek out educational visits and consultations to determine whether you or a loved one qualifies for hospice care. Your physician can offer you options but ultimately it is your choice of which hospice works best for you.

Cathy Huizar-Rea is a community educator with St. Gabriel’s Hospice. St. Gabriel’s Hospice serves patients and families regardless of gender, national origin, race, religion, sexual orientation or age. Cathy is a parishioner of St. Margaret Mary’s Parish.

 

 

Archbishop José H. Gomez of Los Angeles served as archbishop of San Antonio from 2005-2010. He is a renowned expert on death and dying issues, and when shepherd of the Archdiocese of San Antonio, he authored booklets, entitled in English, A Will to Live: Clear Answers on End of Life Issues, and, in Spanish, Anhelo de Vivir: Repuestas claras relacionadas con el fin de la vida. These booklets are part of The Shepherd’s Voice Series,” published by Basilica Press. The following are excerpts:

Q: What is palliative medicine?
Palliative medicine or palliative therapy, which is used in terminal illnesses when the possibility of a cure no longer exists, seeks to alleviate the patient’s symptoms and accompany him or her in death. Among the various forms of palliative care, analgesics and sedatives control pain play an important role.

For example, treatment for the symptoms of widespread cancer is considered palliative. In this regard, the Catholic Church declared several decades ago that the use of narcotics to subdue pain is permissible when other medications are not available. Even when narcotics may limit consciousness and may indirectly shorten the lifespan as a consequence of their use, they are permitted as long as they do not prevent the patient from fulfilling his or her religious or moral duties.

Palliative therapy is included within the methods of palliative care “which seek to make suffering more bearable in the final stages of illness and to ensure that the patient is supported and accompanied in his or her ordeal.”

Palliative medicine neither prolongs life nor causes death. It does not seek to eliminate the patient but rather the suffering or pain that afflicts him. It also attempts to provide the patient a sense of comfort and well-being. Such palliative methods of treatment are initiated in the presence of a reverent, generous and attentive health care worker who serves the terminally ill in a way that “gives confidence and hope to patients and makes them reconciled to death.”

Q: ¿Qué es la medicina paliativa?
La medicina o terapia paliativa se utiliza en enfermedades terminals cuando ya no existe ninguna posibilidad de mejora, busca calmar los sintomas del paciente y acompañarlo hasta su fallecimiento. Entre las diferentes formas de cuidado paliativo que se conocen, los analgésicos y sedantes juegan un papel muy importante.

El tratamiento para los sintomas del cancer se considera paliativo. Respecto a esto, la Iglesia Católica declare hace algunas décadas que el uso de narcóticos limitan el estado de consciencia de las personas y pueden reducer su tiempo de vida como consecuencia de su uso, su consume puede permitirse siempre y cuando no impidan al paciente llevar a cabo sus obligaciones morales y religiosas.

La terapia paliativa entra dentro de los medios de cuidado paliativo destinados a hacer más soportable el sufrimiento en la fase final de la enfermedad y, al mismo tiempo, asgurar al paciente un acompañamiento humano adecuado.

La medicina paliativa no prolonga la vida ni acelera la muerte, tampoco busca eliminar al paciente sino al dolor o sufrimiento que lo aflige, mientras intenta tambien brindarle un sentido de comodidad y bienestar. Los tratamientos paliativos se inician delante de un Agente Sanitario reverente, generoso y atento, quien trata al enfermo terminal de un modo que ‘le proporciona confianza y esperanza, y permite que se reconcilie con la muerte.’

 

 

By Melie McKnight, M.A.P.M.
Director of Hospital Ministry Archdiocese of San Antonio

Palliative care is different from hospice care in that the palliative team usually consists of a doctor, nurse, chaplain and specialist in the medical field pertinent to the patient (e.g., a pulmonologist). They meet with a family to explain what can and cannot be done and how best to help the family and patient (if conscious) to understand what’s next.

While patients are in a hospital, they should seek a priest (which may be the hospital’s chaplain) to receive the sacrament of the sick (formerly known as sacrament of the dying).

If the hospital chaplain is not a priest, the hospital chaplain can contact a priest to administer the sacrament, as requested by the patient (or family member, if the patient is unable to communicate).

The sacrament of the sick can be requested before surgery or just going in for a minor procedure.

Many times, a patient leaves a hospital for hospice care and then a priest is called to come administer the sacrament of the sick — which the priest does readily. But just being admitted to the hospital is enough to ask for a priest to anoint the patient.