Demanding (Hospice) Decisions: Care vs. Cure

A singular vowel makes each word distinct from the other. They are among the simplest of four-letter words in English . . .

Cure.

Care.

However, the choice between the two represents one of life’s toughest decisions. There are a few core basics when explaining hospice. None are easy to hear. All can make someone, and those who love that someone, unsettled, scared, angry, numb.

  • Entering hospice means there are six months or less to live.
  • A hospice doctor you’ve never met, along with nurses, social workers, and other “strangers,” will now help make your health-related decisions.
  • For many hospice patients, the medications given—morphine, Ativan, methadone—are the “bad” drugs. Aren’t these so-called medications addictive or for “crazy people” or only offered when pain is unbelievably unbearable? Addiction, craziness, and pain never appear on anyone’s bucket list.
  • And, of course, hospice means care rather than cure.

Care vs. Cure. That’s the kicker. That’s the hospice gut-check. Abandoning a hopeful four-letter word over that other one-syllable word changes . . . everything. Your life now has a clock ticking away. Strangers arrive at your door, claiming to “help” you. The medications you’re offered are never featured on the pharmaceutical commercials with happy families and well-behaved dogs and a voice-over racing through the nasty side-effects that promote the newest drug for the best cure. Read More →

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Why Do Patients Refuse to Meet the Hospice Chaplain?

My boss and I had a brief, pleasant disagreement about the title of “chaplain.” She (I hope this is a fair summation) worries that certain hospice patients refuse a chaplain’s visit because of the title.

Could introducing someone as a “chaplain” lead to a closed door?

I think my boss is right. And . . . wrong.

Even though she’s correct 98.3% of the time (please tell her I said that), I wonder if the stumbling block is what a chaplain is perceived to represent. Wasn’t Shakespeare correct in “Romeo and Juliet:” What’s in a name? That which we call a rose by any other word would smell as sweet? Whether the chaplain is Jewish or Buddhist, a layperson or professional clergy, volunteer or paid, they all carry the fragrance (or stink) of . . .

Religion.

Since ordination in 1977, I’ve had various titles: deacon, elder, minister, pastor, associate pastor, senior minister, lead minister, new church start pastor, campus minister, hospice chaplain, and currently a bereavement support specialist. When a new hospice staff member or a grieving family member asks about my background, I’ll mention I’m a United Methodist clergy.

Religious.

Not good? Good? An open door? A closed door? Read More →

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Ascites and Other Less Obvious Ailments

How easy it can be to downplay our emotional or spiritual anguish.

Occasionally, a nurse at the hospice team meeting will give an incomplete report about a patient. The team leader will prompt the nurse to make sure all the basics are covered. Though my medical knowledge is limited (and that’s a generous assessment), I’ve gone to the meetings long enough to ask a few of the predictable questions . . .

  • Does the patient require oxygen? Is it continuous or as needed?
  • Is he bedbound?
  • What is her F.A.S.T. score?

Because of situations with several recent patients, I’ve added another subject to ask if a nurse forgot to include the information in her overview.

  • Any sign of ascites?

Huh? First, let’s get to the simple, safe stuff: ascites is pronounced uh-site-teez. Read More →

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